Chronic pain (long-term) is pain that has lasted past the standard healing time of the body. Pain that has lasted for at least three months is also described as chronic pain. Chronic pain causes many issues, including fatigue, anxiety, depression, and reduced life quality, beyond the pain itself. Chronic pain can be a risk factor for compromised self-care and physical functioning, morbidity, and reduced life quality. It is one of the most common reasons adults seek medical care.
Non-communicable disease is a leading threat to global health. Physical inactivity is a large contributor to this problem; in fact, the WHO ranks it as the fourth leading risk factor for overall morbidity and mortality worldwide. At least four of five adults in Canada do not meet the Canadian Physical Activity Guidelines of 150 minutes of moderate-to-vigorous physical activity (MVPA) per week.
The WHO has defined physical activity as “any bodily movement produced by skeletal muscles that require energy expenditure, including activities undertaken while working, playing, carrying out household chores, traveling, and engaging in recreational pursuits.” The WHO also states that “exercise … is a sub‐category of physical activity that is planned, structured, repetitive, and aims to improve or maintain one or more components of physical fitness”.
Major Categories of Physical Activity are:
- Aerobic exercise has long been studied as a treatment for chronic pain. Aerobic exercise includes both land-based exercise, such as walking and stationary cycling, and aquatic exercise.
- Strength training, defined as contracting muscles against resistance, can be accomplished using free weights, resistance machines, elastic bands, and resistance against water or one’s own body weight. Strength training for fibromyalgia and chronic pain is well-supported.
- Flexibility training includes exercises to improve joint range of motion and reduce muscle stiffness. Flexibility training, alone, for treating chronic pain was modestly beneficial for pain with a more significant emotional effect.
- Interest in the effects of movement therapies such as yoga, Tai Chi, and Qigong has gained momentum for chronic pain. Generally, movement therapies are performed at a lower intensity and are safe and well-tolerated in this population.
For most chronic pain patients, the goal of participating in physical activity is to reduce pain. Recent studies have shown that multimodal exercise programs that include a range of activities (aerobic, resistance, and flexibility exercises) effectively reduce pain in osteoarthritis, fibromyalgia, chronic low back pain, and rheumatoid arthritis.
For patients with chronic pain, improving physical function is nearly as important as improving pain. Like pain, a multimodal physical activity program, including aerobic, strengthening, and flexibility exercises, will significantly improve physical function.
Depression and anxiety are common among chronic pain patients. Poor muscle strength, a sign of inactivity, is associated with depression, anxiety, and reduced health-related quality of life. Physical activity is commonly accepted to elevate mood in the general population, and the effect extends to chronic pain patients.
Individuals with chronic pain conditions may exhibit systemic inflammation due to their illness or due to comorbid diseases. Physical activity is known to mitigate cellular inflammation.
For a person, physical activity and exercise can be personalized and is something that people can do to support themselves. Compared to medication and surgical treatments, it is likely to be associated with fewer adverse effects, such as drug interactions and the potential for abuse in adults with chronic pain.
So, exercise plays a vital role in our overall health and wellness. With proper exercise:
- The body becomes fitter, healthier, and more powerful.
- The body’s stability, poise, and balance are enhanced.
- You can better feel the body’s movements.
- Pain relief is achieved through the regular performance of prescribed exercises.
- Obesity, high blood pressure, osteoarthritis, and migraines can be managed.
Exercise prescription usually refers to a particular exercise-related workout schedule tailored for a specific purpose. It is often created for the client or patient by a primary care provider or rehabilitation specialist. The purpose of exercise prescription should be based on encouragement and customization because of the patient’s particular and unique needs and desires, thus achieving objectives more likely to be successful.
Exercise prescription is successful at improving levels of physical activity. It can show positive clinical results, such as decreased blood pressure and glycosylated hemoglobin, significant positive mental health benefits, reduced risk of depression, and increased cognitive performance in older adults with dementia and Alzheimer’s disease.
Studies show that exercise prescription:
- aids in both preventing and minimizing the effects of joint disorders such as osteoarthritis.
- has beneficial effects for patients suffering from depression
- is considered to be part of a non-pharmacological strategy for migraine prevention.
- improves diabetes management
- not only recommended for preventing many types of cancer but is now recommended as part of treatment for many cancers