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  • Writer's pictureDr. Brandon

What to do when exercise flares chronic pain


One of the quickest ways to get knocked off track when it comes to your fitness goals is a pain flare. This is especially true for those that deal with fibromyalgia, chronic fatigue, and myofascial pain syndrome. Often they are doing all the right things including trying to get 30 minutes in a day of exercise, trying to eat right, staying hydrated but still they end up in a flare. So, why does this happen and moreover, what can be done about it.

First, a bit about what pain is. When somebody is dealing with persistent or chronic pain, often the seemingly smallest things can cause a flare-up. Anything from just going for a walk to a light yoga or pilates class or even simply cleaning the house can cause days if not a full week of wanting to stay in bed just to get away from the pain. This leads to a familiar “boom-bust” cycle known to just about everybody who suffers from chronic pain. The “having a good day so you try to take care of everything on the to do list” followed by the crash. This is doubly difficult when wanting to exercise. So, why does this flare your pain? The answer is not what you might think. It is not likely to be a fresh injury or a reinjury of something that happened before. Especially when you are months if not years out from that injury. So, why does it hurt? Your body was built with an amazing alarm system designed to keep you safe. Its called your nervous system and it has roughly 45 miles of those nerves all throughout your body. It is also equipped with a bunch of danger detectors that let your body know when it needs to pay attention to an area. The problem with those danger detectors is that they become more sensitive after an injury and for some they get stuck on sensitive(i.e. Pain that happens when no additional damage happens). In addition, these danger detectors have special sensors that can be triggered by things such as change in temperature(does your pain tell you about the weather? This is why), it can be triggered by stress or sleeplessness, it can be triggered by your immune system(just think to the last time you had the flu and your whole body ached and old injuries were even worse), and it can be triggered by pressure(think of how long you used to be able to sit if you’ve been dealing with back pain and now how you have to change positions just to get comfortable). Plus, the longer pain has gone on, there are more of these sensors on the danger detectors This works like a sticky keyboard, you hit one key but get 5 of the same letter on the screen. This can create pain with seemingly little activity or effort. So, with an alarm system set to extra sensitive, it is a little bit easier to see how even light activities can trigger pain, especially when so many other things can set off pain. It can seem that there is no hope when things have gotten that bad. But, the good news is that chronic pain can be walked back. A stuck on alarm system can be “reprogrammed” but it takes time.


How to begin easing chronic pain with activity.

First, grab some pen and paper because we need to map out how much you can do before you have a flare. Don’t skip this step. Once you understand how much you can do before you have a flare, then you can begin planning your activity around it. Let's take walking for an example. You notice that you can only walk 15 minutes before you notice your pain getting worse. Before then, you were OK. But your goal is 30 minutes, so you usually push through to get your steps in and suffer the consequences(and sometimes days off because of pain). So, if you notice that you begin to get worse after 15 minutes, know this, you are very likely not injuring yourself but your alarm system is being triggered by the amount of time you are moving. So, we then do our exercise at a level below what usually triggers it. That’s either stopping just before it consistently gets worse(so in this case, you may walk 10-13 minutes then take a break). This break can be just long enough for you to then do another 10 minutes(without triggering) or it can mean a walking session in the morning and then another later in the day. That’s OK, it still counts and it also begins to unlock your body’s healing system.

Second-go back to your pen and paper map of what causes a flare. If stuff at work or home flares your pain, mark how much you can do before you have a flare. If your job has different duties and you are able to switch between them, then set a timer to do that(don’t wait until the pain is bad enough to force you to change). If you are taking care of the house, you can do the same map. Let’s say that if you try to vacuum or sweep the whole house at a go and you are laid up after, chances are your body was telling you so. So, once you know what it takes to flare we then divide your house up(even if the size you are working on seems small, this will make a massive difference in how you feel). Let’s say you have 5 rooms but the living room is massive plus 2 bathrooms. Now, you notice that if you try to do the living rooms and the bathrooms in the same day, you are laid up or it flares your pain. But you notice that your pain begins halfway through the living room. Your plan is to divide the things that make it worse in the living room and tackle part of those one day and part the next. Say it is vacuuming the living room. Set a boundary and vacuum that portion(the amount before your pain flares) and then stop(I can already hear you wanting to yell at me through the screen…but stick with me here, your body will thank you). Once you’ve done that half, go do something that relaxes you(you can come back to the other half later…I won’t tell). Now, you may be able to finish that the same day or it may be the next, either way, give yourself some grace, this will improve. Map the same out for the rest of the house.

The third thing is to then map out what your “perfect day” looks like. This is the kind of day that if somebody waved a magic wand over you and everything was better kind of day. What would you do? Now, lets find which one of those “wins” from your perfect day would make you feel good about an average day. You may only have 2 or 3 that would help you feel like the day was not lost. Again this is OK, it gets better. These are the 3 wins that you’ll try to get every “average” day. Now, of those 3, what one or two absolutely must happen on a “bad day”? These are the ones that would make you feel bad if they didn’t get done or that it was a completely lost day. Now, these days have to be re-evaluated probably monthly because if you stick to them, you’ll find that you are able to do more because you’ve found what wins are the most valuable for you(try to make sure that getting 5 minutes of outdoors activity is part of it-trust me, you’ll feel better just being outside). The key here is to keep track, you’ll often find that you are able to do more week in and week out because you’re avoiding the boom-bust cycle of chronic pain.

Does making this roadmap seem like only wishful thinking? Are you confused about where to start? Speak with one of our chronic pain specialists for free from the comfort of your own home. Interested in getting to the root of your pain? Schedule your free in person consultation, our Total Body Diagnostic Test. During one of our free consultations, the Total Body Diagnostic, we offer expert advice about the worry and frustration of life-changing aches and pains – for FREE, in under 30 minutes.

If this article describes your story and you are looking for some help with chronic pain, we offer FREE consultations, which give you the opportunity to come in and meet us and see for yourself how we can help you.

Here are just a few of the things you will learn in one of our free consultation:

  • What is the underlying cause of your pain? (hopefully nothing too serious!)

  • Roughly, how long will it take to fix the problem?

  • What to do to help – which doesn’t include painkillers, resting or surgery etc.

  • What other, natural, drug free methods are there to speed up recovery alongside treatment?

About the author

Brandon Alkire, DPT, CSCS, FMS, Cert. DN Doctor of Physical Therapy and Strength Coach Dr. Brandon is the owner and a Physio at Body Mechanix Physiotherapy and Fitness. Four of his favorite people call him daddy while he's been married to his other favorite person for 20 years. He enjoys teaching martial arts and is a Mestrando in Capoeira while in the mornings, he can be found working out with the guys in F3 around town. He's the author of 4 pain relief guides for sciatica, low back, shoulder, and knees and the lead contributor to the Active Tallahassee Blog.


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