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How should we deal with chronic pain? New research says movement can help



The researchers found that participants who reported moving more often had a higher pain tolerance than sedentary participants. The more active people are, the higher their endurance capacity is.

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The two questions these findings raise are: Why does physical activity have this effect? And can the pain-relieving effects of the ‘hands in ice’ study be generalized to other conditions?

Why?

The study’s lead author, Anders Årnes of the University Hospital of Northern Norway, says there are many reasons why exercise might affect our perception of pain.

“Engaging in activity releases chemicals in our nervous system that activate pain-inhibiting pathways,” he says. “In fact, these are the same pain-suppressing pathways as opiates and cannabinoids use, and thus, in some respects, the effects of physical activity are ‘brothers’ of those substances. “

Professor James McAuley, a senior research scientist at the Australian Institute of Neuroscience Research and the UNSW School of Health Sciences, adds that the activation of the brain’s endogenous opioid pathways, through collective sex, can protect people from the painful part, so they can still have pain but not suffer it as much.

Physical activity also affects inflammatory markers in the body, which can make us more sensitive to pain.

Then there are psychological effects that can affect how the brain processes pain. Physical activity can regulate stress and anxiety, help us focus our attention, and reduce the likelihood of severe pain.

“If you can boost someone’s confidence,” says McAuley, “being active can also improve ours.”

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Although he said it was a “great paper” with a large dataset, he added that there could be other explanations for the relationship between physical activity and pain tolerance. . It is possible that people who naturally choose to be more physically active have better pain tolerance or have adjusted to pain by pushing themselves and have exercise-induced muscle pain.

“It’s great to tease,” McCauley said, explaining that it’s not yet clear whether prescribing exercise to people who are inactive will reduce their pain or make them more tolerable.

Can physical activity improve chronic pain?

Arnes admits that chronic pain is “a completely different monster” from the pain of dipping your hands in ice water.

“We don’t fully understand what causes pain to persist this way. However, some theories suggest that this individual’s ability to process pain signals may be a contributing cause,” he said. “Since physical activity also appears to be a useful tool for the prevention and treatment of chronic pain, we are trying to determine whether this effect on pain sensitivity is related. to that or not.”

Professor Manuela Ferreira from Musculoskeletal Health Sydney and the University of Sydney says exercise is “the way forward” to preventing and treating chronic back pain.

“Our spine is made to move,” she said.

By maintaining physical activity during the acute phase of pain (first six weeks), albeit at a gradual decline, and by having a physiotherapist or exercise physiologist design a program If the pain becomes chronic (longer than 12 weeks), it can be helpful in reducing pain. countless ways.

Exercise Increases blood flow and nutrients to the soft tissues of the back, improving the healing process and reducing stiffness that can lead to back pain. It also strengthens the muscles around our spine.

“It gives stability to our internal organs and trunk,” she explains.

However, the first thing many people do when they have back pain is to stop moving, says Ferreira: “That will actually cause other problems with the muscles and joints… that load support. More load on small joints instead of muscles.

And not moving reduces a person’s confidence in their ability to move around freely, she added.

The amount and type of physical activity that works best is still poorly understood, but Ferreira, lead author of the paper that predicts an increase in back pain by 2050, believes we can. prevent and treat it.

“Most of that [estimate] driven by population aging and population growth… we can’t change that,” she said. “However, we have not invested in prevention strategies and made sure people know they can move. Exercise and physical activity are safe. We need to change people’s attitudes and knowledge about back pain. If we do that, we can reduce the number.”

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