Chronic Pain – Ashley Johnston AEP

Chronic pain can be quite a debilitating condition for many however with the right treatment, symptoms can be managed and controlled.

Chronic pain is the defined as the development of persistent pain symptoms extending over a period greater than 3 months. It can result from a number of conditions and injuries, and can affect the bones, joints or tissues within the body.  

With chronic pain there comes other factors individuals face that can influence the amount of pain they are experiencing, such as fear of movement, pain catastrophising, anxiety and the nervous system sensitisations appearing to have increased pain based effects.

All of these elements need to be addressed to work towards managing chronic pain. However the greatest factor is the continued movement of the individual so that they can continue with their activities of daily living without having pain restrict what they feel they can do, be or participate in.  

There have been a number of studies that indicate that exercise is an appropriate intervention as it can improve pain and functionality levels. With exercise there can be  improvement seen in an individual’s strength, endurance and mobility, but it can also improve mood, thought patterns, fear reduction, reduction of anxiety, improved pain self-efficacy and decreased catastrophising.

Depending on the individual there are a number of exercise interventions that could be of benefit. Such interventions could be resistance, light aerobic, hydrotherapy, yoga and pilates to name a few.

However no two individuals are the same so no two exercise interventions should be the same. Each intervention should work towards what the individual wants such as managing pain and/or improving movements.

Fundamentally what should be included in an exercise program is mobility based exercise. By including mobility exercise an individual can work towards improving their confidence in the movements thus having a slight effect in decreasing fear based movement avoidance. Strength/ resistance or muscle activation based exercise are also important to be included. Through improving an individual’s strength it can have the effect of making movement easier and more efficient thus improving ones confidence.

When developing an exercise based intervention there should also be considerations that there are recommended guidelines that can be followed but they are not always best for the individual. So therefore having a lower number of sets and reps or even working to a smaller amount of time  to start off then working to slowly increase over time.  The most important consideration is that the participation in exercise is enjoyable for the individual.  

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