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Exercise regularly

Patients with a variety of pain problems are told to rest, and in fact the best response to many acute injuries is rest. However, prolonged rest and inactivity is almost always detrimental. This is because prolonged rest, even in healthy individuals, leads to significant protein and calcium loss, decreased efficiency of the cardiovascular system, and even changes in the nervous system and immune function. In short, as human animals we are built to move and regular, vigorous movement is essential to keep the systems of our body functioning.

It is interesting to note that several recent studies by Dr. Wendy F. Sternberg and colleagues from Haverford College in Pennsylvania have scientifically documented what many of us already believed; vigorous exercise leads to decreased pain sensitivity (probably by activation of our own pain control system described above).

The opposite is probably also true, namely that very low activity levels increase pain sensitivity and therefore increase the level of discomfort in patients with an ongoing pain problem.

Regular exercise is also an excellent way to help decrease depression and anxiety, and help with weight loss. You will need to pace activities if you have a pain problem that makes exercise difficult.

Swimming, walking, and riding an exercise bicycle are safe ways to increase fitness and decrease stress. As discussed below, several traditional forms of exercise such as yoga, tai chi, or chi gong may also be of significant benefit for patients with pain.

Be positive but realistic

Research on coping has shown that catastrophizing or focusing only on the worst possible outcome is a common roadblock to patients taking positive control over their problems. In pain management we often ask patients to challenge common but irrational automatic thoughts such as, "I will never be able to ... again," or "My life is now meaningless." It is also not helpful to tell oneself that "Everything will be fine" because that may not be true.

Instead, substitute a more positive and rational thought such as, "I am having a difficult time but I have survived similar bad periods" or, "There are still some options to try."

In a similar way, you should more clearly define what in your life you can and cannot control. Increased worry and focus on things we cannot control is usually not productive. Instead, efforts should be aimed at those aspects of our condition we can influence or change.



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