Exercise Provides Protection Against Pain – Sometimes

Exercise Provides Protection Against Inflammation—and Pain – RELIEF: PAIN RESEARCH NEWS, INSIGHTS AND IDEAS – May 2016

Exercise seems to be the latest panacea offered for chronic pain. Story after story proclaims that exercise cures/prevents pain, and this infuriates me.

I was a competitive endurance athlete who exercised constantly even as my pain became more and more severe. I modified my activities to lessen my constant back pain and switched from running to bicycling, but I still ended up with debilitating and disabling pain.

My experiences with pain are the opposite of what this article suggests.

There is no cure for chronic pain, but there are practices that can help patients keep pain at bay. For example, exercise has been proven to ease some types of chronic pain.  

That one little word “some” nullifies all these rosy projections because which pain is helped and under what circumstances is never stated.

That some painful conditions, like EDS, can be aggravated by exercise is never mentioned as a possibility.

Now, research in rats shows that exercising before an injury may lessen the severity of future chronic pain.

If pain is truly a bio-psycho-social disorder, then rats can never be models for human pain.

Peter Grace, working with Linda Watkins at the University of Colorado, Boulder, US, allowed rats access to a running wheel inside their cages for six weeks, while rats in a control group had access to a locked, nonfunctioning wheel.

After six weeks, the researchers tied sutures around the sciatic nerve in some of the rats, an injury meant to model neuropathic (nerve injury-induced) pain. Rats no longer had access to the wheel after surgery.

Two weeks after the nerve injury, rats displayed a hallmark of neuropathic pain called mechanical allodynia

But, among those with the nerve injury, rats that had freely exercised were less affected by the injury

“What was striking is that the protection persists over the life of the injury,” Grace says.

Exercise affects pain through its influence on the activity of immune cells, though exactly how is unknown.

Evidence is piling up that exercise protects against pain.

This is strange to hear when so many people with chronic pain from Ehlers-Danlos Syndrome were extremely active before their pain started.

Because of the extreme flexibility of EDS, quite a few were competitive gymnasts who developed crippling chronic pain afterward.

“Our study provides some insights as to how that protection might occur, by promoting an anti-inflammatory environment,” Grace explains.

Although the research was done in rodents, it may have a lesson for people hoping to avoid future pain, such as those undergoing a planned surgery. “Stay active!” Grace says.  

Again, rodents cannot possibly model the biopsychosocial impact of pain.

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14 thoughts on “Exercise Provides Protection Against Pain – Sometimes

  1. Laura P. Schulman, MD, MA

    Considering that athletes often go for it because of the endorphin high and our competitive can-do nature, it’s not surprising that we push through outlandish amounts of pain before we hit that final wall that cripples us.

    There’s nothing that triggers me more than being told I’m lazy, malingering, trying to get out of working, etc. These people who are “temporarily able bodied” consistently ignore my statements that I was an athlete literally all of my life before this thing cut me down: ballet, gymnastics, running, track, soccer, horseback riding, Latin and Ballroom dancing…every athlete knows, “push through the pain, push through the wall….” But then there’s that other, new wall that we can’t push through, so they call us “weak,” they call us that word that is the ultimate insult to an athlete: “quitters.”

    Fuck a bunch of rats. My rats in medical school experiments, when cruelly wounded, would chew their own limbs off in an effort to rid themselves of the source of their pain. I suppose that could be interpreted as resilience.

    Yes, I think that because you and I were athletes, we were able to push way, way further beyond the onset of pain before we were crushed by it, compared to others who were not accustomed to dealing with the “normal” pain of training on a daily basis. Add to that the pain of running and dancing on hypermobile joints….but hey, I’m just glad I got to do it, even though the pain of being sidelined far exceeds the physical part of the pain….

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  2. Zyp Czyk Post author

    How awful: “chew their own limbs off in an effort to rid themselves of the source of their pain”!

    As horrifying as that is, it’s not so different from how I react when I’ve been suffering from an excruciating headache for too long: in my frenzy for escape, I whack my head against a solid wood door hard enough that the flash of extra pain temporarily overrides the headache pain.

    Like those poor rats chewing off their limbs, even a change to worse pain is welcome when intolerable pain is so unrelenting. Escape from that agony becomes a need that almost overrides self-preservation.

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    1. painkills2

      Since I broke my foot, I’ve noticed that it has distracted me from the pain in my head. It’s like the pain in my foot has taken over most of my pain signals, redirecting them. But as my foot starts to feel a little bit better, my head is like, remember me? There’s no escape.

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      1. painkills2

        I’m not sure that it does. And I think it doesn’t make sense to say that acute pain is a treatment for chronic pain, which is kinda the result of my little experiment.

        I think there is more than one kind of acute pain. For instance, if I had broken my foot during a pain storm, I doubt it would’ve distracted me from it. In fact, a pain storm could’ve distracted me from the acute pain of a broken foot.

        Thinking about it further, I’d say that while chronic and intractable pain can make one think of suicide, the acute pain of a broken foot does not. But the acute pain during a pain storm will definitely put those thoughts in your head.

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        1. Laura P. Schulman, MD, MA

          I agree with you there. Pain storm is a very good way to put it. Mine often start with a blast from my bad shoulder, and the pain seems to propagate from there and generalize to most of my body. I become paralyzed by it. I would kill myself then if I could only move, but I can’t. I can’t move! All I can do is to lie down as quiet as I can and wait for it to pass. I’ve gone hours and days where the only thing I could do was literally crawl to the bathroom and to let the dog out. Is that what your pain storms are like, J and Zyp?

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            1. Zyp Czyk Post author

              Wow, my pain flares aren’t THAT bad. My level 10 pain is when I broke 3 metatarsal bones in my foot in a childhood accident. By definition, we can only have one “worst” pain we can imagine and that’s it for me.

              Everything else therefore only goes to nine, and that’s where my pain flares take me. Often, they come from visceral pain which feels like adhesions, like something is tearing my flesh inside, and there’s nothing I can do about it, nothing!

              That pain has made me start scratching my nails into my arms, leaving bloody streaks. But it is such a sweet relief to shift my pain even for a little while. The worst was when a previous doc had cut back my pain meds, so those were the results.

              The headaches luckily didn’t come during that time and I’ve always had pain meds to defend myself. But meds can take up to 2 hours to work (for me) and during that time I get pretty frantic.

              I guess Stanford’s Beth Darnell would call that catastrophizing – when I start whacking my head against the walls and tearing bloody gouges into my arms. If a psychologist like she tried even talking to me while I feel like that, her life would be in danger :-)

              Liked by 2 people

            2. painkills2

              Funny, I’ve never thought about my “worst” pain, which you’re saying is a 10 on the pain scale. Thinking about it now, I’m not sure if I could pick just one. I mean, on the top of the list would obviously be 36 hours of labor and a c-section, but that pain is a very distant memory. I think this is just another example of how limiting the 1-10 pain scale really is. Because the pain from labor and major surgery might have been a 9 or 10, but it never made me think about suicide.

              And our efforts to distract ourselves from the pain — whichever method we use — is another example of how ineffective painkillers can be. They work, but only to a degree. There has to be a better way. Sure, cannabis works on a variety of symptoms, instead of just one, like opioids. But it doesn’t work for everyone. I suppose nothing will — our pain is too different. As I like to say, our pain is as unique as our DNA. And a 1-10 scale cannot measure it.

              There should be a separate pain scale for chronic and intractable pain, one that includes the nuances of these conditions.

              Liked by 1 person

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