The pain relieving magic of exercise.
Why is it every time you go to physio we give you exercises ? Usually it's to get you stronger, more flexibility or movement or even to get you fitter and healthier. Those exercises have another purpose and we are just beginning to understand how it works.
Why you need to do your homework?
We also give you exercises to help decrease pain and it's all because of your spectacularly clever body. Little did you know that you are in possesssion of a very powerful medicine cabinet. This dispensary makes some pretty awesome chemicals that are very powerful pain relievers.
So how does this pain relief work ?
The science behind the pain killing effect of exercise is in its infancy. It relates to chemicals that are produced in various parts of the body, from the brain to the immune system right down to the muscle tissue. This knowledge has mainly been developed from nerve related injury and has looked at both aerobic and resistance style exercise.
The majority of our knowledge comes from animal studies, you wouldn't want to be a wistar rat that's a fact.
Where are these magic chemicals working to get rid of pain ?
These chemicals work at various levels of the body. From a whole body perspective including the brain to a local tissue effect. Even more encouraging is that it doesn't take alot to make a positive difference.
Opioids in the brain and nervous system
As an old patient of mine once told me she exercised because the dolphins were good for her pain. We had a chuckle as she realised it was the endorphins, but dolphins in the brain sounded pretty cool as well.
The runners high is the result of these endorphins being released and they give us the feel good effect. In other good news these chemicals and their related cousins are very powerful pain killers as well.
Their release can create a cascade effect of other chemicals that further enhance this effect by acting on relevant regions of the brain. All you need to access them is to get moving.
The nervous system.
In nerve tissue following an injury there is an increase in chemicals that promote pain. These are know as pro-inflammatory cytokines.
They are necessary in the early days of injury to help with repair but often outstay their welcome contributing to unecessary pain.
The good news is that exercise reduces these pro inflammatory chemicals and INCREASE your own anti-inflammatory chemicals.
These chemicals also act in the areas of the spinal cord, (Dorsal horn) that look after the area of the body you may have injured. So the pain relieving affect occurs not just at the site of injury but on the higher structures that look after it.
This can occur with just one bout of exercise, whether it is a general type of exercise such as swimming or a more joint specific rehab exercise.
The Immune system response.
It may come as some surprise that the immune system has a very important role in pain. Then again it may not be so surprising becaues the aches and pains you suffer when you have the flu are the result of the immune response.
In the past few years we are starting to understand that the immune system is incredibly important in pain. This has led to the discovery of immune cells working in close proximity to neural tissue.
Studies in nerve related pain have shown that running helps to increase the activity of immune cells that ease pain. This can take place with a single bout of running or swimming. It also decreases the immune cell activity that helps generate the pain response. Very similar to what occurs with the cytokines.
Motion is lotion
In summary the internal medicine cabinet (exercise and doing your physio homework) that you own is incredibly powerful and readily accessible. We don't just give you exercises to get stronger or more flexible. We also give it to you to ease your pain.
Exercise and physio homework is a weapon in your armoury to combat acute or chronic pain and it costs nothing.
I think the Madagascar crew sum it up beautifully in the video below;