When movement is painful: what are your options?

1 in 5 Canadians experience persistent pain. If you or a loved one live with persistent pain, you have likely heard that remaining active and engaging in exercise are important to your overall health and management of symptoms.  

Lifemark clinicians, registered physiotherapists Neil Pearson, Tanya Nichol, and Daniel Godinho, and kinesiologist, Logan Miller, shared knowledge and practical tips in an informative webinar where they discussed pain management approaches, both from lived experience of patients as well as how research supports persistent pain care in practice.

The webinar covered the following questions, commonly asked by many people:  

• How much pain is okay during exercise? 

• What options do I have besides pushing through or avoiding activities that increase my pain? 

• If pain is not a good guide for when to stop or modify activity, what do I do? 

Below are 4 key takeaways from this webinar, to learn more please check out the video above. 

1. Gaining knowledge of pain is the first step to moving with more ease. 

The role of pain is to act as a protective mechanism. Acute pain is more closely related to the tissues and can promote healing of an injured site, while chronic pain is related to changes in the body, including the nervous system, that can limit healing and negatively affect recovery. In persistent pain, where discomfort lasts longer than 3 months, the alarm system often becomes hypersensitive, resulting in pain being triggered more easily, frequently, and in some situations even before engaging in an activity which may indicate “danger” to the alarm system. In this situation, pain is not a reliable indicator of danger and therefore not a useful guide for how much to move. 

2. Body awareness and calm breathing can help build awareness of body sensations. 

When experiencing pain, the body often becomes tense and stiff, or breathing patterns change from slow and steady to shallow, quick, or even holding of one’s breath. Increasing body awareness through mindfulness activities helps us to sense when our muscles are tense and when we are breathing in a way that might turn on   our protective systems. In other words, if we notice tension in our muscles or in our breath this should queue us to breathe more calmly and release gripping in muscles, both of which can help to decrease pain. Practising body scans also helps us to pay attention to the body’s non-pain sensations such as skin temperature or the feeling of clothing covering the area which can help reduce the body’s alarm system response.  

3. Mindful movement is a technique to help move with pain. 

Remember, pain is like an alarm system and when pain persists the alarm can be triggered too soon. With movement and activity when in pain, we can be more successful if we choose movement that is gentle yet slightly challenging – something that moves us up to the edge of increased pain, or even to the place where the body starts to tighten up or the breath pattern changes. Finding the edge, where protective mechanisms just start to increase, is a learning process. With practice, gently challenging this edge can help reduce pain with movement over time.  

4. Pain care is for life.  

Managing persistent pain starts with goal setting. There are 3 P’s that can increase success when it comes to pain moving with more ease. Planning involves creating a schedule ahead of time of when and how often to practice movement, body scans, and calm breathing exercises. Creating a plan also involves recognizing that flareups happen, and with proper techniques, it is possible to calm pain down after too much activity, or if pushed past the edge of pain. Practice of these techniques helps to retrain and decrease the alarm system to a natural/less sensitive state. Finding an accountability partner or linking practice to other daily tasks can act as reminders to keep consistent with activities to help reduce pain. Patience, the final P is key to success as pain reduction takes time and repetition.  

What should I do if my pain continues to worsen with activity or exercise? 

At Lifemark we know that even the best self-care plan isn’t always enough for success. Persisting pain is complex. It can require a plan that includes knowledge or an approach specific to your unique pain condition, be guided by a clinician who understands the complexities of chronic pain, or one that includes individualized treatments that support your self-care. Other times, the movements you are doing continue to feel unsafe and you may benefit from modifications or reassurance to find movement that not only is safe but feels it too. 

If you are struggling with where to begin or how to progress, a trained pain care clinician can help.  

You don’t need to figure this all out on your own, and we are here to support you. 

When pain persists, there are many options for care. Change is possible and there is good reason for hope. 

If you would like to learn more or address your pain concerns, book online here.