Pain is a sensation often accompanies arthritis. It is the major reason people seek medical attention. In 1994, Merskey & Bogduk of the International Association for the Study of Pain, defined pain as, “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” Dorland’s medical dictionary lists 34 types of pain. In Dorland’s definition of pain, it states, “pain serves as a protective mechanism in so far as it induces the sufferer to remove or withdraw from the source.”  Pain associated with arthritis and its various forms is generally caused by inflammation of tissue in and around joints or mechanical failure of a specific joint structure. Individuals suffering from arthritis are often hesitant to participate in exercises for fear of making their condition, and ultimately their pain, worse.

  We know exercise is an excellent way to manage, reduce and control pain associated with arthritis. However, before engaging in any exercise program, you should be evaluated by a qualified professional.

  Exercise is beneficial in facilitating positive emotions and decreasing negative emotions and pain. Exercise significantly alters the body physiology and brain chemistry. Though the exact mechanism is not completely understood, there are several ways we know exercise works:

·         Exercise increases the output of endorphins. Endorphins are naturally occurring opiate-like substances in your brain that produce mild euphoria and fight to decrease pain.

·         Exercise increases your brain’s supply of serotonin. Serotonin contributes to the flexibility in blood vessels which improves circulation to tissue. Serotonin increases your overall mood and regulates your sleep cycle helping you to sustain a more fitful sleep.

·         Exercise also contributes to stabilizing estrogen. Estrogen is a sex hormone that can interfere with serotonin. 

John Ratey M.D., Associate Clinical Professor of psychiatry at Harvard Medical School and the author of, The Users Guide To The Brain:  Perception, Attention In the Four Spheres of The Brain (Vintage books, 2002), says that “exercise does in fact activate part of the limbic system.”  This is the part of the brain that regulates emotion.  “Aerobic exercise is the single best way to increase levels of a biochemical called Brain Derived Neurotrophic Factor (BDNF).”  This biochemical is involved in memory and alertness. 

There is also a well-known phenomenon of exercise, particularly rhythmic type exercises, called somatoemotional release (soma referring to body).  John Upledger D.O., OMM, the founder of craniosacral therapy (a gentle type of body work that concentrates on the membranes and the cerebrospinal fluids surrounding the brain and spinal cord) believes that negative emotions and pain is stored in tissues of the body. By releasing this energy, it contributes to an overall sense of well being and raises the one’s tolerance to conditions such as arthritis.

A report in the Journal of Rheumatology (August 2002) concluded that therapeutic exercise can help reduce pain and the physical function of people with osteoarthritis of the knee.  This conclusion was based on a review of literature. The helpfulness of exercise in dealing with pain and arthritis is obvious. However, it is important to also know how much and what kind of exercises to perform.

There are several other factors that contribute to the success in any exercise program.

The three main parameters of exercise include:

·         Frequency (how often one exercises)

·         Intensity (how hard one exercises)

·         Duration (how long one exercises)

There are also several forms of exercise: 

·         Aerobic conditioning is exercise that primarily works to exercise the cardiovascular system and usually involves some form of prolonged rhythmic activity. The goal of aerobic exercise is to raise the heart and respiratory rates.  It typically involves the larger muscles of the body such as the legs.  Aerobic exercise can be performed in various setting depending on the joint’s condition and severity its pain. Examples include a pool setting, modified weightbearing such as a bicycle or elliptical trainer, or full weightbearing with gentle walking, hiking, or stair climbing.

·         Strengthening exercises include the use of gravity or various forms of resistance to challenge the muscles and other tissues of one’s body. Strengthening muscles that surround a particular joint can help to unload the stresses for that joint, thus protecting it.

·         Flexibility training is primarily geared towards increasing the elasticity and range of motion of the tissues surrounding the joint.

Each of these exercise routines has a specific goal and purpose.  Each of these exercise types can be beneficial in increasing one’s tolerance to the physical and emotional demands of the day, particularly when one has arthritis in one or more parts of the body.

There are several factors that can directly affect one’s ability to exercise. Diet can have an effect on your ability to exercise. The intake of caffeine and alcohol will alter your response to exercise and pain. Proper hydration with appropriate fluids such as water and sport replacement drinks is essential. One who is rested prior to exercise or has good control of their daily stress can improve the outcomes of exercise and should be considered.

It’s important to note that actual benefits of exercise do not occur while one is exercising. Instead, it is during rest periods that the tissues of the body respond to the physical activity and produce its beneficial effect.

Though there are many forms and types of exercise. It is key to begin a routine designed for your particular circumstances. You must have a competent assessment of your physical capability, your persona as it relates to exercise and availability of exercise environment. Remember, when you are ready to begin a new exercise program, check with your doctor or health care practitioner.

For more detail related to types of exercise programs and joint protection during exercise and activities of daily living, see other articles on this website.

© Copyright 2005. Arthritis Education by Professionals, Inc.