Managing Chronic Pain: Is Exercise Safe for Arthritis Sufferers?

Widespread muscle pain?

Hello Dr.
Lee,
I have been suffering from chronic lower back pain for many years, and for the past five years, I have also been troubled by knee pain.
I have visited multiple clinics, and the doctors have prescribed painkillers or suggested physical therapy.
However, I am concerned about the potential kidney damage from taking too many medications, so I am cautious about their use.
I have undergone physical therapy several times, but honestly, I have not felt any significant improvement.
It seems that my time and money have been wasted.
I have come across reports stating that individuals with pain should also engage in exercise.
I have always been an exercise enthusiast, but due to "degenerative arthritis," I have been hesitant to go hiking, running, or playing sports for fear of exacerbating my condition.
However, after hearing related reports, I started playing table tennis for 1 to 1.5 hours and walking briskly for about 30 minutes (approximately 2.5 kilometers) about 3 to 5 days a week.
During my walks, I experience little to no back pain, and my knee pain has also decreased.
However, sometimes I experience slight discomfort after intense table tennis sessions, but overall, my condition is manageable.
I would like to ask Dr.
Lee the following questions:
1) Given my situation, is it safe for me to continue exercising, or could I be unknowingly causing further harm to myself?
2) I live in constant discomfort, including when lying in bed, getting up from my desk chair, rising from the sofa, and getting in and out of the car.
I endure this pain daily, which severely affects my sleep and quality of life.
I fear that in a few years, I may become unable to get up or lose my autonomy in moving my limbs, which terrifies me.

3) I have previously consulted orthopedic and rehabilitation specialists but have never seen a pain management specialist.
Would it be more appropriate for me to consult a pain management specialist?
I sincerely hope Dr.
Lee can provide detailed guidance and explanations regarding my concerns.
I look forward to your response.
Thank you very much!

Tòngtòngrén, 60~69 year old female. Ask Date: 2013/05/27

Dr. Li Weiqiang reply Rehabilitation

Hello! For the past five years, I have been suffering from knee and lower back pain.
I have visited outpatient clinics multiple times, and the doctors have prescribed painkillers or suggested physical therapy.
I'm hesitant to take too many medications due to concerns about kidney damage.
I have undergone physical therapy several times, but honestly, I have not felt any significant improvement.
It seems like my time and money have been wasted.

I have come across reports regarding health and medicine that suggest individuals with pain should also engage in exercise.
I have always been an exercise enthusiast, but due to "degenerative arthritis," I have been afraid to hike, run, or play sports for fear of exacerbating my condition.
However, after hearing related reports, I started playing table tennis for 1 to 1.5 hours and walking briskly for about 30 minutes (approximately 2.5 kilometers) around 3 to 5 days a week.
While walking, I do not experience back pain, and my knees rarely hurt.
However, sometimes I feel slight pain after intense table tennis sessions, but overall, my condition is manageable.
1) Given my situation, is it possible that I am exercising in a way that could be causing harm without realizing it? Is the amount of exercise I am doing sufficient, and should I just avoid intense activities? The idea of exercise is that if you feel discomfort afterward, it might be too much.
With summer approaching, swimming is an excellent and suitable activity for someone who loves to exercise like me, and it could replace walking.
2) I live with pain throughout the day, including when lying in bed, getting up from my desk chair, rising from the sofa, and getting in and out of the car.
I endure life with the mindset of "grinning and bearing it." This has severely affected my sleep and daily life.
I fear that in a few years, I may be unable to get up or lose my ability to move my limbs independently, which terrifies me.
I try to avoid sitting on low sofas or chairs, as standing up from them is very difficult.
Maintaining such positions long-term is also detrimental to my body.
When pain arises, lying down is preferable, but I need to get up regularly (at most every two hours) to change my position.
3) I have always consulted orthopedic and rehabilitation specialists but have never seen a pain specialist.
Would it be more appropriate for me to consult a pain specialist? I need a thorough evaluation to determine if I should see a pain specialist.
You are welcome to visit my clinic for assistance.
Wishing you peace and health.
Director of the Rehabilitation Department, Taoyuan Hospital, Ministry of Health and Welfare, Li Wei-Chiang.

Reply Date: 2013/05/27

More Info

Managing chronic pain, especially in the context of arthritis, can be a complex and challenging endeavor. Your concerns about whether exercise is safe and beneficial for your condition are valid and deserve careful consideration.
Firstly, it is essential to understand that arthritis, particularly osteoarthritis, is characterized by the degeneration of joint cartilage and the underlying bone. This condition can lead to pain, stiffness, and decreased mobility. While it may seem counterintuitive, engaging in regular, low-impact exercise can actually be beneficial for individuals suffering from arthritis. Exercise helps to strengthen the muscles around the joints, improve flexibility, and maintain a healthy weight, which can alleviate some of the stress on the joints.

Based on your description, it appears that you have been proactive in managing your condition by incorporating activities like table tennis and walking into your routine. These activities are generally considered low-impact and can be beneficial for maintaining joint health. However, it is crucial to listen to your body. If you experience pain during or after these activities, it may be a sign that you need to adjust the intensity or duration of your workouts.
1. Is it safe to continue exercising? Yes, as long as you are mindful of your body's signals. It is important to differentiate between discomfort from exertion and pain that signals potential injury. If you find that certain movements or activities exacerbate your pain, it may be wise to modify those activities or consult a physical therapist who specializes in arthritis management. They can help design a personalized exercise program that takes your specific limitations into account.

2. Living with chronic pain: Chronic pain can significantly impact your quality of life, affecting your sleep, mood, and daily activities. It is understandable to feel fearful about the future, especially if you are concerned about losing mobility. It may be beneficial to explore additional pain management strategies beyond medication. This could include physical therapy, acupuncture, or cognitive-behavioral therapy, which can help you develop coping strategies for managing pain.

3. Consulting a pain specialist: Given your ongoing struggles with pain, it may be worthwhile to consult a pain management specialist. These professionals can offer a comprehensive approach to pain management, which may include medication, physical therapy, and alternative therapies. They can also provide guidance on how to safely incorporate exercise into your routine while managing your pain effectively.

In conclusion, exercise can be a valuable tool in managing arthritis and chronic pain, but it must be approached with caution and awareness of your body's limits. It is essential to find a balance between staying active and preventing further injury. Regular check-ins with healthcare providers, including pain specialists, can help you navigate this journey and improve your overall quality of life. Remember, you are not alone in this, and there are resources and professionals available to support you in managing your condition effectively.

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