5 ms·

Perhaps naive but from NPR this morning: "For people who live with chronic pain, getting up, out and moving can seem daunting. Some fear that physical activity

by Wistar 7y ago

Perhaps naive but from NPR this morning: "For people who live with chronic pain, getting up, out and moving can seem daunting. Some fear that physical activity will make their pain worse. But in fact, researchers find the opposite is true: The right kind of exercise can help reduce pain." https://www.npr.org/sections/health-shots/2019/09/23/754869132/exercising-to-ease-pain-taking-brisk-walks-can-help https://www.npr.org/sections/health-shots/2019/09/23/7548691...

rjurney 7y ago
This is true to some extent - use it or lose it. They also teach you to know your limits so your pain doesn't flareup and put you in bed for a week. You learn this delicate balance this over time, to push yourself just enough but not too much. At first you hurt yourself constantly because your body can do whatever you want - right? But no. Not now. That fact doesn't really make it easier to get out of bed. Your brain tells you not to move, that you're injured. Rest. Its an animal thing. You have to overcome it each morning, and all day long. And unfortunately that takes energy. It drains you. You have much less capacity as a result. Everything in life is harder. You do the best you can. This is the reality of disability. It fucking sucks.
jrace 7y ago
And this is where using pain meds can help. Get the pain down to a lower level and then you can attempt to do normal functions. Key being not so much pain reduction that you can cause physical harm (masking good pain response). I know (second hand) what chronic pain can do to the desire to get up and function. It destroys it. My SO has lived with it for almost 20 years now, and is due to live with it the rest of her life. There is no cure for her condition. You cannot fix the root cause (sympathetic nerve dysfunction) She can only hope to numb the signals to allow her to see past the pain.
justinator 7y ago
"Motion is Lotion"!
GordonS 7y ago
I can understand how, for some conditions, exercise could help, not just physically, but against the depressing effects of chronic pain. But absolutely not for all conditions. For too long, doctors have pushed graded exercise programs for essentially all chronic pain conditions, despite good evidence that it can be harmful, even permanently, for some conditions (e.g. CFS). I personally suffer from chronic pain, caused by small fiber neuropathy. I used to love walking, and I want to exercise - but if I do too much it can take days or even weeks to recover. A few times, I'm fairly sure I made things permanently (or hopefully semi-permanently) worse. So, yes, exercise does help some people, but we must be careful not to push it as the be all and end all.
- cpncrunch 7y ago
  >good evidence that it can be harmful, even permanently, for some conditions (e.g. CFS). No, there is certainly no evidence that exercise can be permanently harmful for CFS. In fact, all the studies show that graded exercise is beneficial. It's certainly true that exercising too hard for too long can be detrimental and can cause a crash, and patients do need to be careful. Exercise certainly isn't a cure for CFS, and I wouldn't recommend graded exercise myself, but it's untrue to say that there is evidence that it makes patients permanently worse.
  - H_Pylori 7y ago
    Another name for cfs is "systemic exertion intolerance disease". This alternative name never caught up, but it does describe the reality of the ilness quite accurately. Post exertional malaise is literally the defining symptom of cfs, so yes exercise in cfs makes you worse. You can tolerate some mild forms of exercise if you have a mild form of cfs, but that's about it. Also stop spreading lies, Simon Wessely's studies are deeply flawed, to say the least.
  - GordonS 7y ago
    It's not true to say there is no evidence[0-9]. The Cochrane review[10] that includes the PACE trial has also been beset with complaints about its methodology[11]. [0] https://www.ncbi.nlm.nih.gov/pubmed/21334061/ https://www.ncbi.nlm.nih.gov/pubmed/21334061/ [1] https://huisartsvink.files.wordpress.com/2018/09/severely-affected-me.pdf https://huisartsvink.files.wordpress.com/2018/09/severely-af... [2] https://www.ncbi.nlm.nih.gov/pubmed/19521443/ https://www.ncbi.nlm.nih.gov/pubmed/19521443/ [3] https://huisartsvink.files.wordpress.com/2018/08/bringsli-2014-me-nat-norwegian-survey-abr-eng-ver-2.pdf https://huisartsvink.files.wordpress.com/2018/08/bringsli-20... [4] https://huisartsvink.files.wordpress.com/2018/07/de-kimpe-2016-rapport-2.pdf https://huisartsvink.files.wordpress.com/2018/07/de-kimpe-20... [5] https://www.nivel.nl/sites/default/files/bestanden/Rapport-draagvlakmeting-CVS-ME-2008.pdf https://www.nivel.nl/sites/default/files/bestanden/Rapport-d... [6] https://huisartsvink.files.wordpress.com/2018/08/eyssens-pem-get-primer-december-2017.pdf https://huisartsvink.files.wordpress.com/2018/08/eyssens-pem... [7] https://www.ncbi.nlm.nih.gov/pubmed/28847166/ https://www.ncbi.nlm.nih.gov/pubmed/28847166/ [8] https://www.ncbi.nlm.nih.gov/pubmed/28805516/ https://www.ncbi.nlm.nih.gov/pubmed/28805516/ [9] http://www.meassociation.org.uk/wp-content/uploads/2010/09/2010-survey-report-lo-res10.pdf http://www.meassociation.org.uk/wp-content/uploads/2010/09/2... [10] https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003200.pub7/full https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD... [11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6176540/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6176540/

by Wistar 7y ago

rjurney 7y ago

This is true to some extent - use it or lose it. They also teach you to know your limits so your pain doesn't flareup and put you in bed for a week. You learn this delicate balance this over time, to push yourself just enough but not too much. At first you hurt yourself constantly because your body can do whatever you want - right? But no. Not now. That fact doesn't really make it easier to get out of bed. Your brain tells you not to move, that you're injured. Rest. Its an animal thing. You have to overcome it each morning, and all day long. And unfortunately that takes energy. It drains you. You have much less capacity as a result. Everything in life is harder. You do the best you can. This is the reality of disability. It fucking sucks.

jrace 7y ago

And this is where using pain meds can help. Get the pain down to a lower level and then you can attempt to do normal functions. Key being not so much pain reduction that you can cause physical harm (masking good pain response). I know (second hand) what chronic pain can do to the desire to get up and function. It destroys it. My SO has lived with it for almost 20 years now, and is due to live with it the rest of her life. There is no cure for her condition. You cannot fix the root cause (sympathetic nerve dysfunction) She can only hope to numb the signals to allow her to see past the pain.

justinator 7y ago

"Motion is Lotion"!

GordonS 7y ago

I can understand how, for some conditions, exercise could help, not just physically, but against the depressing effects of chronic pain. But absolutely not for all conditions. For too long, doctors have pushed graded exercise programs for essentially all chronic pain conditions, despite good evidence that it can be harmful, even permanently, for some conditions (e.g. CFS). I personally suffer from chronic pain, caused by small fiber neuropathy. I used to love walking, and I want to exercise - but if I do too much it can take days or even weeks to recover. A few times, I'm fairly sure I made things permanently (or hopefully semi-permanently) worse. So, yes, exercise does help some people, but we must be careful not to push it as the be all and end all.

cpncrunch 7y ago
>good evidence that it can be harmful, even permanently, for some conditions (e.g. CFS). No, there is certainly no evidence that exercise can be permanently harmful for CFS. In fact, all the studies show that graded exercise is beneficial. It's certainly true that exercising too hard for too long can be detrimental and can cause a crash, and patients do need to be careful. Exercise certainly isn't a cure for CFS, and I wouldn't recommend graded exercise myself, but it's untrue to say that there is evidence that it makes patients permanently worse.
- H_Pylori 7y ago
  Another name for cfs is "systemic exertion intolerance disease". This alternative name never caught up, but it does describe the reality of the ilness quite accurately. Post exertional malaise is literally the defining symptom of cfs, so yes exercise in cfs makes you worse. You can tolerate some mild forms of exercise if you have a mild form of cfs, but that's about it. Also stop spreading lies, Simon Wessely's studies are deeply flawed, to say the least.
- GordonS 7y ago
  It's not true to say there is no evidence[0-9]. The Cochrane review[10] that includes the PACE trial has also been beset with complaints about its methodology[11]. [0] https://www.ncbi.nlm.nih.gov/pubmed/21334061/ https://www.ncbi.nlm.nih.gov/pubmed/21334061/ [1] https://huisartsvink.files.wordpress.com/2018/09/severely-affected-me.pdf https://huisartsvink.files.wordpress.com/2018/09/severely-af... [2] https://www.ncbi.nlm.nih.gov/pubmed/19521443/ https://www.ncbi.nlm.nih.gov/pubmed/19521443/ [3] https://huisartsvink.files.wordpress.com/2018/08/bringsli-2014-me-nat-norwegian-survey-abr-eng-ver-2.pdf https://huisartsvink.files.wordpress.com/2018/08/bringsli-20... [4] https://huisartsvink.files.wordpress.com/2018/07/de-kimpe-2016-rapport-2.pdf https://huisartsvink.files.wordpress.com/2018/07/de-kimpe-20... [5] https://www.nivel.nl/sites/default/files/bestanden/Rapport-draagvlakmeting-CVS-ME-2008.pdf https://www.nivel.nl/sites/default/files/bestanden/Rapport-d... [6] https://huisartsvink.files.wordpress.com/2018/08/eyssens-pem-get-primer-december-2017.pdf https://huisartsvink.files.wordpress.com/2018/08/eyssens-pem... [7] https://www.ncbi.nlm.nih.gov/pubmed/28847166/ https://www.ncbi.nlm.nih.gov/pubmed/28847166/ [8] https://www.ncbi.nlm.nih.gov/pubmed/28805516/ https://www.ncbi.nlm.nih.gov/pubmed/28805516/ [9] http://www.meassociation.org.uk/wp-content/uploads/2010/09/2010-survey-report-lo-res10.pdf http://www.meassociation.org.uk/wp-content/uploads/2010/09/2... [10] https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003200.pub7/full https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD... [11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6176540/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6176540/