There is good evidence for benefit of exercises in many of these painful conditions. The aim is to do as much as you can comfortably, but to pace activities so that you do it regularly and aim to increase slowly. Space out your daily activities rather than doing everything in one attempt! Have a reasonable and realistic goal and aim to achieve it in a step-wise manner.
Exercises, Education and Learning to cope take more importance than treatment in the management of chronic pain conditions.
Exercises: The evidence shows that pain can make muscles stiff and more painful. Simple relaxation methods, massage, yoga and mindfulness meditation methods can help to prevent and break this vicious cycle.
Walking, swimming and cycling are good simple exercises. Your physiotherapist can guide you appropriately. Joining an exercise programme will encourage and motivate you to do them regularly; as well as improving your social life.
Sleep: Establishing a regular sleep pattern and avoiding day time naps can improve the quality of sleep and avoid day time tiredness. Try to go to bed at same time in night to maintain the pattern. Avoid coffee or tea before bedtime; having a warm bath before bed and not watching television can help to give better sleep. All treatment and management techniques should be evaluated in improving your quality of sleep also.
Planning: Persistent pain can cause tiredness and fatigue. Try to prioritise your work so that you do that hardest when you feel better. Pace your activities having intermittent breaks.
Diet: Having a healthy diet pattern with lots of fruits and vegetables can improve the pain suffering. Oily fish (grill or oven and not fried!), besides helping in heart disease, can also help in some types of arthritis. Eating less sugar and fat is also important.
Dr Thanthullu Vasu MBBS MD DNB FRCA Dip Pain Mgt FFPMRCA FIPP