A Pain Specialist Explains The Anatomy of Walking with Chronic Pain
By Austin Horrocks, D.O.
Chronic pain can make any of us into a bit of a hermit. It’s hard to do the things we love to do when they’re physically challenging or even painful. It can be easier to withdraw from certain activities and social obligations.
This is where walking comes in! It may seem small in comparison to the magnitude of things you want to do. However, it’s a great place to start.
Walking has numerous physiological and psychological benefits for people struggling with chronic pain. It can also be just the thing to help you ramp up your physical exercise and get back into the swing of doing what you’ve been missing.
How Walking Can Help People With Chronic Pain
If we dive into the multitude of benefits that walking can offer to someone with chronic pain, it won’t be long before you’re convinced! There’s almost nothing that walking can’t do for you.
First off, walking improves blood flow and circulation. When blood flows better to muscles, tendons, ligaments, and to all the other parts of your body that may be experiencing pain, it carries nutrients along and replenishes them, while washing away lactic acid that’s built up. Lactic acid can cause pain, especially in muscles, so this is great for pain relief. The increased blood flow that comes from walking is critically important to decreasing stiffness and improving range of motion.
Second, the act of walking improves your core strength, which can help people suffering from low back pain achieve relief. Walking requires you to use your core and to activate your core muscles, all without going to the gym and doing a bunch of sit-ups or other more strenuous activities. Walking can be a great, low-impact way to tone your core and build muscle back up.
Next, walking can decrease adipose tissue. If you’re walking regularly, you’re most likely losing weight. This weight loss decreases adipose tissue, which is pro-inflammatory. With the decrease of this inflammatory tissue, you’ll experience less systemic inflammation. In addition, there will be less stress and weight on your joints, which will help to decrease irritation and painful aggravation.
Another benefit of walking is an increase in synovial fluid, which is the natural lubricant that exists in your joints. It makes the movements of your joints smoother and easier, which can be impactful for people with joint pain.
Psychologically, exercise increases your body’s release of its own chemicals that are the body’s natural pain-fighting system and can inhibit your pain pathways the same way that some prescription medications do.
Walking can also decrease depression and combat other mental health issues. Getting outside, building up your stamina, and reclaiming the physical aspects of your life are all critical for feeling better psychologically. Chronic pain does a number on our brains, as well as our bodies. We lose out on some of the important things in life, feel less social, and less capable in our daily activities. Walking can help to boost your mood and outlook. All of the things you want to do are possible, as long as you start small and build up your strength and stamina.
Which People Living With Chronic Pain Benefit the Most From Walking?
Anyone living with chronic pain should always check with their doctor before starting a walking routine or plan. Some people have specific limitations on movement that make excessive walking harmful or unhelpful.
However, once your doctor okays a walking routine, you can get started. For folks with lower back pain, walking can help to improve your core strength and combat pain. For anyone with fibromyalgia, increased blood flow can be very beneficial. People with fibromyalgia also often suffer from comorbid psychiatric illness or depression. Walking can target those things as well and lessen your load.
For those with osteoarthritis or rheumatoid arthritis, the extra synovial fluid is critically important for lessening joint pain. Research has even shown that walking can help people who suffer migraines! And for all of us, studies have been pointing to the physical and psychological benefits of aerobic exercise.
Getting your heart rate up is great for blood flow, circulation, and all-over health. Just 15-60 minutes a day of an elevated heart rate and aerobic exercise have an amazing effect on the body. Of course, it’s important to discuss a healthy heart rate with your physician. All of us are different, and your doctor can help you set a target heart rate to reach or let you know if aerobic exercise isn’t safe for you right now.
How to Start a Healthy Walking Process and Scale-Up
When you’re starting on your walking journey, it’s important to start low and go slow. Just like any other type of exercise, if you decide to go from 0 to 100 in a short period, you’re going to end up feeling terrible. Start with a very achievable goal and build up slowly. It can help to set an ultimate goal to reach, whether it’s taking your children or grandchildren to the park, walking a certain number of blocks, or just feeling better in general!
That ultimate goal will help you to stay motivated and focused, even when you’re tired and sore. You have to be willing to put in the work to reach that goal because it will take time and you’ll run into some resistance from your own body. Sometimes you’ll feel a little push back or a bit of discomfort as your body grows and as your muscles respond to stress.
As you exercise, your muscles will feel stressed before they get bigger and stronger. If you’re not stressing those muscles, they’re going to atrophy and you’re going to be de-conditioned. The next time you try, it may hurt when you get up and walk. That’s why it’s important to set a routine and a habit of walking.
A great way to build that habit is to find a support group or walking partner. Try reaching out to a family member or a friend to get together and go for a walk a couple of days a week. It will help you stay motivated to keep at it because you’ll have someone to talk to and to be encouraged by. I know that when I work out if I have a workout buddy that I know is going to be there when my alarm goes off in the morning before work, it’s a lot harder for me to stay in bed. Having a walking buddy is great for accountability. Where it might be easy to blow off the exercise if it’s just you, it’s a lot harder if you’re letting someone else down.
The Multidisciplinary Approach to Pain Management Includes Walking!
I’m an anesthesiologist, but I did a fellowship in pain management and I’m a pain management physician. I first decided to do pain management because I had a back injury when I was young. I had a herniated disc and an epidural steroid injection, which is something that I do for others today. It was debilitating, and I couldn’t do a lot of the things I wanted to. Chronic pain starts to play with your emotions and you can end up feeling stuck and helpless.
When I was going through my treatment for the injury, I had a pain doctor who proposed this treatment plan for me. He told me that if I followed this treatment plan, I would maximize my ability to do the things I wanted to do.
I’m now an osteopathic physician, which means that I’ve had more extensive training than most physicians on the musculoskeletal system.
There are so many layers to that system and so many minute ways for things to go wrong or cause some kind of pain. The body is an entire system, made up of other delicate systems and each of these individual parts needs to be functioning well for you to move the way you want to move. When there’s a problem, you feel it. Whether or not you can see that problem on an MRI is largely irrelevant. However, there are very few of those problems that you can’t see on the MRI that are not made better with exercise.
Remember, it’s probably not going to be easy or pain-free at first, but the benefits to your mental and physical health will be more than worth it! It kickstarts the process of taking your life back from chronic pain. When you make the choice to get out and start walking, you’re starting to tell your body, I know that it hurts, but I’m going to do it anyway.