THE LINK BE T WEEN
Physical Activity, Pain, A N D Mental Health There was a recent, beautiful late summer day in which I had decided to do a little yard work. For a few hours, there was lots of squatting & standing, digging and pulling. I knew by the end of my work I would pay the price later, and yet I continued. Of course, the next day I was sore, my back ached, and my fingers felt stiff and swollen. Still, there is something about being outdoors, working in the yard or in the garden, or just going for a walk, that boosts my mood, even when I know I will be sore the next day. Many of us who suffer from arthritis, fibromyalgia, or other chronic pain syndromes, wonder if we are actually doing more harm than good when it comes to moving. Often, our pain can flare up after intense exercise, forcing us to take the next few days or week to slow down and recover, which hardly seems worth it. Our significant others and friends may even try to tell us to take it easy, and not push ourselves too much, but as proven above, we sometimes (or often), don’t listen. So, should I exercise if I have chronic pain? The answer is a resounding YES! As difficult as it may seem to get moving when you are already feeling stiff & painful, inactivity is likely to worsen joint pain, increase stiffness, and decrease flexibility. There is also good evidence that depression and anxiety are linked to physical pain. The same neurotransmitters used to regulate mood (serotonin and norepinephrine) are also used in pain pathways in the brain. If you have chronic pain, you are more likely to be depressed or anxious. One study showed that people with depression are three times more likely to develop chronic pain, while those
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with chronic pain, are 3-5 times more likely to develop psychiatric symptoms. So, what’s the good news? Although lack of exercise can worsen our mental health and pain, regular exercise has the power to improve it! Exercise stimulates nerve cell growth in the hippocampus, the part of our brain that regulates mood. Often this region is smaller in those who are depressed. Exercise helps build it up, and therefore improves brain function, decreases pain, and helps with mood regulation. It doesn’t have to be intense aerobic exercise either; low-intensity exercise sustained over time is better.
TOP 5 REASONS EXERCISE IS KEY: Stability: Exercise strengthens the muscles
around your joints, making them more stable and help to take the pressure off the joints themselves.
Flexibility: Gentle stretching keeps muscles loose and less likely to cramp. Improved sleep: A more active day helps us to feel more tired and sleep better at night. Mental health boost: Aerobic exercise
is just as effective as antidepressants in many people, boosting our serotonin and norepinephrine naturally, and growing our hippocampus for better mood regulation.
Excuse to get outside: You can’t always exercise outdoors, but do it as often as you can. Even gardening has been found to have
mental health benefits! Japanese physicians are known to write prescriptions for outdoor therapy. They call it, “Forest Bathing.”
EASE INTO IT
Simply, too intense of a workout, too soon, can cause pain to flare up. The important thing to remember is to start out easy, and slowly increase the duration and intensity. Even if this means starting out with a five minute walk, three times a week. Doing gentle yoga, riding stationary bikes, and swimming are often easier on the joints, for example. Sometimes we need medication for depression or anxiety, injections, or even surgery for pain, but these are not the only treatment options. So how about it? How can you start exercising to feel better? Get the family involved, set goals together. A brief walk every day may be the best place to start boosting your mood, lessening your pain, and in the end “add years to your life and life to your years.” Marti Peters-Sparling, MD is a board certified Family Medicine physician and co-owner of an integrative Direct Primary Care wellness center, SWMI Health Matters. She has experience in preventative care, chronic disease management, meditation, and mindfulness. Dr. Peters-Sparling seeks to meet her patients wherever they are, without judgement or bias.
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