“I’m afraid that exercise will make my pain worse as every time I try it, I pay for it for a few days afterwards”
– A person dealing with chronic pain
Before judging patients with chronic pain as having “fear avoidance beliefs”, answer this question, “If every time you banged your head against a wall you got a headache and you eventually learned to avoid doing it, is that fear avoidance?”
If every step one takes produces a #7 out of 10 pain, why would anyone in the right mind voluntarily choose to go for a 20-minute walk?
Sure, exercise may certainly increase pain for some; however the OPTIMAL type, intensity and duration of exercise with the OPTIMAL mindset may certainly reduce pain in the short term and in the long term.
The potential analgesic benefit of OPTIMAL exercise with an OPTIMAL mindset is due to several potential neurophysiological reasons… so it is multimodal and complex.
For example OPTIMAL exercise stimulates endogenous opioids, testosterone to increase central inhibition and stimulate serotonin, anti-inflammatory cytokines to decrease central excitability.
Since the potential analgesic benefits of exercise is systemic and not just local, start with a body part that is distal to the region of pain. If someone has low back pain, do upper body exercises. If someone has chronic neck pain, start with leg strengthening.
If someone has left arm pain, start with exercising the right arm. You get the point!