Here’s a particularly nasty little Catch-22 for CP dolls: We’re told over and over that exercise will help us feel better, yet post-exertional pain — that is, exercise-triggered pain — is a prime cause of our bad days and fibromyalgia flares.
The truth of this quandary has been driven home in a very in-your-face kind of way to me in the last month. Four weeks ago, I began feeling bad — I mean really, really bad. Most of the day, every day, I rated my overall pain levels at a six out of ten, often increasing to seven or eight at times. (Normally, my mean pain level is three or four, topping out at six right before the next dose of tramadol is due.)
And what happened next is easily predictable by anyone living with a chronic pain illness: I stopped moving. I withdrew into myself, stayed glued to the heating pad on the couch, and whimpered through my day.
Doing so only made logical sense: when I had to move — say, when I went to the bathroom, or took a shower, or cooked dinner (on the days I was even capable of making dinner — there were a boatload of pizza boxes passing through our house last month!) — the pain levels increased. I walked around the house with a shuffling, “disabled old woman” gait, grabbing my back or hip in futile attempts to stop the searing pain.
And as for sticking to my daily routine of 20 minutes of walking and 30 minutes of gentle yoga? Forget it.
This went on for four weeks. I might feel slightly better for a few days, but then I’d go right back into debilitating pain. I joked that I’d invented a new yoga pose: the Couch Potato position.
A “DIY” Two-Day Intensive Pain Relief Program
Then, this past weekend, I decided it was time to get serious about feeling better. For two solid days, the only thing I paid attention to was my health and my pain level:
- I ate low on the food chain: vegetables, fruits, whole grains, minimal meat.
- I took my multivitamin every morning.
- I drank water and caffeine-free tea, eliminating all sodas and artificial sweeteners.
- I took hot baths, followed by a rub-in of Tiger Balm on the particularly sore spots.
- I meditated three times a day.
- I took my full complement of prescribed pain medication (flexeril and tramadol), as well as the maximum safe dose of acetaminophen.
It was extreme, but desperate times call for desperate measures. Yet as exhausting as that list may seem, there was one more thing I did for those two days, and it’s what I think truly tipped the scales for me:
I moved, almost constantly.
Movement vs. Exercise for Chronic Pain
I won’t dignify what I actually did by calling it “exercise” — mostly, it consisted of simple stretches from a seated or prone position, twisting from side to side in a very gentle arc while standing, and so forth. I set a goal for myself: for every five minutes of inactivity, I’d do one minute of movement.
Sitting on the couch watching cartoons with my daughter? Flex and point my feet, alternating left and right. Or reach up to the ceiling and stretch one side of my ribcage and then other.
Cooking dinner? I’d do simple calf and hamstring stretches. Or gentle shoulder circles.
And yesterday, after two days of this intensive approach, I felt good. Not just better, but actually good.
Now, I do not think that not moving caused the flare-up in the first place. As I said, I usually walk and practice yoga every day. But that gingerly-moving, couch-sitting approach, born out of self-preservation as it was, may well have made things a whole lot worse.
The Painful Results of Inactivity
Like the amateur scientist I fancy myself to be, I treated this as an experiment. I had a working hypothesis — gentle, regular, consistent movement helps to stave off flare-ups of chronic pain, while a lack of movement will increase pain levels.
So I set about testing it. To test the hypothesis, I willingly went immobile this morning. No movement. Sat on the couch and watched Law & Order: SVU for hours on end.
And right now, as I write this, at 2 PM EST, one full hour after my afternoon dose of pain medication, I do hurt a little more than I did at any point yesterday.
Is this proof? No, of course not. But it does support the experts who have been telling us all along to get up and move, if we want to feel less pain.
I’m not about to suggest exercise is the end-all, be-all of pain management. That’s ridiculous. But I am suggesting that some form of movement or exercise may be a vital part of a comprehensive pain management program.
Finding Your Movement Sweet Spot
So why am I not advising you to go join the Y or start running? Because I think the experts have only half the picture right. The other half is just as important, and it’s this: the reality of post-exertional pain flare-ups.
We all know it. Move too much — do too much — walk too much — practice yoga too long, even — and you’re going to pay for it the next few days.
What this tells me, the pseudo-scientist with the curious mind and the half-full bottle of tramadol, is this: there’s a sweet spot, and it’s the job of each CP doll to find her own.
In between the “extremes” of post-exertional pain and couch-potato-induced pain lies a middle ground that will help you feel better. The problem is that those “extremes” can be pretty darn close together on a spectrum of effort and movement. Walk ten minutes and you’re feeling great. Walk another five minutes and you’re in bed for two days.
And there’s another complication: sweet spots for the chronically pained — even those with the same exact CP illness — will, I suspect, vary wildly. That’s true for the same reason that our general experiences with chronic pain illnesses vary so much from person to person: because chronic pain illnesses implicate so very many different facets of daily life.
From nutrition to stress to genetics to medication to body chemistry to sleep hygiene … it all plays a part, and every new facet gives the illness another level of complexity.
Exercise — movement — whether and how we use our bodies — this plays a part, too. Your mission: find your sweet spot, and attain that level of movement each day you are physically able to do so.
How to Get Moving and Find Your Sweet Spot
A few tips before you get going:
- Talk to your doctor first. Make sure you’re healthy enough to do some activity.
- Start slowly and gently, with movements and stretches such as the ones I described above.
- Begin with where you are — not where you want to be, or where you used to be. This one’s hard for me, personally. I used to be a dancer, and in some part of my mind, I can still go for thirty minutes at the barre and sixty on the floor. Of course, I can’t. I have to get my ego out of the equation, and stick to my “sick person” routine. Because that’s where I am now.
Let me know in the comments what you think about exercise as part of a pain relief program. Do you exercise? Can you tell what’s going to trigger a post-exertional flare when you’re doing it, or does it always surprise you when you can’t crawl out of bed the next day? Are you physically capable of exercise? Also, be sure to visit Euston Arch on Thursday, when I’ll look at some commonly suggested forms of exercise for chronic pain conditions.