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Put pain relief in motion
Decades ago, the standard advice for all kinds of pain was to sit still, take it easy and not exercise. Strain on the body, doctors feared, would just make things worse. Today, that position hasn't just changed, it has practically reversed. "If 20 or 30 years ago we didn't encourage patients in pain to move about, now the opposite has been proven," says Lucie Brosseau, a professor of rehabilitation epidemiology at the University of Ottawa. "When we measure outcome, exercise actually reduces the amount of pain."
Brosseau spearheaded a team evaluating exercise's impact on a range of musculoskeletal diseases. Her group's analyses show that exercise regimens of all sorts appear to be good. With arthritis, for example, tai chi and yoga significantly increase mobility and muscle strength while decreasing pain. Walking, stretching, in-pool and out-of-pool aerobics can also bring down pain while raising physical abilities. "It is all very encouraging that we know that exercise is beneficial because exercise is natural and noninvasive," says Brosseau.
There are qualifications for exercise therapy, however. One of the most important ingredients in getting better through movement was having someone check up to ensure people followed their regimen. Regularly seeing a doctor and reviewing exercise regimens kept participation levels up and pain levels down.
Even if you don't formally exercise while in pain, this review suggests that just keeping up normal movement is good. The report concludes, "Even in an acute episode, maintaining activity levels such as staying at work is one of the most important things you can do." For those with back pain, these findings are easily summed up with this motto: Don't take back pain lying down.
Compared to back pain, headaches are a more confusing situation. Some people experience "effort headaches" or "exertional headaches" with activities as varied as weightlifting and swimming. The cause is unclear, although higher altitude and heat seem to contribute. Because they're generally of a limited duration, the best way to deal with them is to rest from the exercise. Discuss symptoms with a healthcare professional, to determine potential causes and triggers for these headaches, and find alternative therapies and physical activities you can pursue to maintain fitness.
In contrast, there have also been reports of men with cluster headaches whose attacks decreased if they engaged in heavy physical exercise. As for migraines, it's known that they can be worsened by exercise-or, for that matter, almost any physical movement. However, a small Canadian study showed that aerobic exercise diminished the severity of migraine pain. Researchers think the release of pain-dulling endorphins associated with intense exercise may be responsible.
So what to do if you suffer headaches? While there is no physical exercise specifically designed to stop migraines or other headaches, organizations such as the American Council for Headache Education and the Mayo Clinic do suggest general aerobic exercise for headache sufferers.
Finally, a note of caution: While all kinds of evidence suggest that moderate exercise can be good for pain, the same cannot be said of excessive exercise. "When you are actively doing an exercise program and start to experience an exacerbation of your pain level, that is an alarm," says Brosseau. "It says: Stop now and reduce exercise."
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