
What Constitutes Movement in Chronic Pain
Heidi Clarke
In chronic pain, ‘movement’ typically refers to the incidental activities or exercises a person engages in, to manage, or for some, alleviate pain.
Chronic pain often leads to reduced mobility and physical activity due to fear around re-injury, exacerbating pain or due to the pain itself. However, active treatments, where the individual living with pain completes the treatment, such as movement, is crucial for maintaining function, reducing stiffness, and improving overall quality of life.
What are key aspects of movement for helping with chronic pain?
1. Exercise Therapy
Structured exercise programs are commonly used to help individuals with chronic pain. These exercises should be designed in conjunction with the individual living with pain and focus on working towards their functional goals. The programs are useful in improving flexibility, strength, and endurance, and have a very important role in managing pain and improving function over time, in addition to reducing overall disease risks as with any person.
2. Incidental Activity
Trying to maintain incidental activity is vitally important to assist in contributing to overall activity completed and maintaining function for activities of daily living. Strategies used to implement exercise therapy, such as pacing, can be used to assist in determining the amount of incidental activity completed and when it is appropriate to add more incidental activity in.
3. Graded Exposure
This involves gradually increasing the amount and/or intensity of movement to build tolerance and reduce fear associated with pain. It’s particularly useful for those who have developed a fear of movement (kinesiophobia) due to pain. This can relate to varying measurements of activity such as the total time of an activity, eg walking for 10 minutes, versus walking a particular distance or speed.
4. Movement Education
Improving someone’s understanding of pain and the science behind it can assist them to engage in positive active management behaviours such as movement. Leaning how movement can positively affect their lives, including pain, can encourage them to engage in physical activities despite their pain.
Pain self-management relies on the provision of strategies to assist the individual to make informed decisions in their care. An important element of self-management is having active strategies to perform rather than passive treatments or strategies that someone does for you. Understanding how and when to make change regarding movement is an important active self-management tool to improve quality of life while living with and managing pain.