Active Wait programme

Week 2 – Managing your pain

Understanding pain

Persistent pain can put up a significant barrier in your life. It is more challenging to do things when you have pain, and it could stop you from doing things you enjoy. There may also be a fear or worry that your pain is a result of harm to your body, which can make you avoid doing things altogether. This may make you feel like your life is on hold or that you are withdrawn from life.

Pain is an unpleasant feeling caused by the interpretation of signals from your nervous system to tell you something may be wrong in the body. If we experience persistent pain for a long period of time, our pain signals can become more sensitive and trigger more often than normal. This means we can often feel pain even though no harm is being done to the body.

Because we understand pain as a warning sign for harm, we naturally want to protect ourselves and avoid being hurt. But many things we might do to lessen long-term joint pain, like avoiding movement, can make pain worse.

The effect of pain

Living with long-term pain is difficult and can lead to a vicious cycle of problems. You may become less active because movement is more difficult or to avoid triggering any pain. However, if we move our joints less, they become stiffer, the muscles that surround them become weaker and this can add to pain.

Pain can have significant emotional effects, like lowered mood, self-esteem, self-confidence and increased stress, frustration, anger, and anxiety. Many things can impact this like poor sleep and reduced involvement in family and social activities. Memory and concentration can be affected by all of this and everyday activities can be a real struggle. Chemicals released in the body from these negative emotions can enhance the pain experience.

Managing long-term pain

Keeping active

Moving the joint regularly through activity is a great way to manage pain. With frequent movement, the joint is less likely to stiffen and the muscles around the joint stay strong ensuring the joint is mobile and stable. Aim to maintain social contact and do activities in and out of the house as much as your symptoms allow. When you do a bit more activity on a regular basis, your body releases feel good chemicals which can improve your mood, relieve stress, and can help with pain. This also builds confidence to do a bit more again enabling you to improve your health and sense of wellbeing over time. When you first increase your activity, it is likely you will still feel pain. That’s okay. It’s important to know that your pain experience is real, but your pain does not mean you are doing the joint harm.

Strength Exercises

Strength exercises help significantly to reduce pain levels. Keeping up with an exercise routine helps maintain the size and strength of the muscles that surround the joint which improves joint stability and the amount of stress the joint can handle whilst moving. If pain is reduced, the joint can handle more movement and loads before pain is experienced, thereby reversing the previously mentioned spiral or sensitivity in your favour.

Managing weight

If you are overweight, weight loss is an important part of managing pain. Weight loss works to lessen pain by reducing the amount of load going through the joints and by reducing inflammation that irritates the joint. A 5% to 10% reduction in weight can reduce joint pain and improve mobility. The more you are able to get towards your ideal weight, the less pain you are likely to have.  Support on managing weight is covered in week 5.

Sleep

It can be difficult to sleep with long-term pain, and a lack of sleep can make pain worse. To improve sleep, it is important to stick to a normal sleep routine. Going to bed at the same time each evening, getting up at a regular time each morning and taking naps only when you really need them can set sleep patterns that improves sleep quality. Avoiding caffeine and watching television/screen use close to bedtime has also shown to improve sleep.

Your weekly exercises

Click the links below to see this week’s exercises. You only need to select one level. Start on the foundation level, and if you find it easy click on the intermediate and advanced exercises for a more difficult version next time.

• Foundation – bed and chair exercises
• Intermediate – chair and standing exercises
• Advanced – standing exercises