In Australia, one in five people experience chronic pain. Pain becomes chronic if it takes longer than the expected time to heal.

It’s important to understand that ‘chronic’ means longer duration and not the severity or the quality of the pain. Many people who aren’t used to this concept are surprised when the pain levels continue, although the injury has healed.

Why does chronic pain occur?

Pain in our bodies is a strong protective mechanism to prevent us from doing further damage. Pain doesn’t just involve the area of injury, but it includes the whole nervous system — your brain, nerves and neural pathways.

If I use an example like tennis elbow pain, the pain occurs on the outside of the elbow. This is the warning signal by the brain saying that you have not used your body in the correct way.

You’ll undoubtedly get treatment on the elbow to correct the tissue damage, improve strength and correct the biomechanics. The brain, however, remembers that the pain was caused by a certain incident. So every time you’re even close to conducting that activity the brain goes into protective mode and creates the pain as the warning signal.

The tissues usually heals in about six weeks but this yo-yo effect with the pain continues until the brain decides that there’s no danger. Unfortunately this process can take time and your window of movement and activity can be minimised terribly.

So can how can exercise help?

In my experience the mantra to use is: any movement is an improvement. Do as little as possible without exacerbating that pain signal. And over time the pain settles as the brain learns that there’s no danger.

Try and create movement in different environments. For example, you may not be able to exercise in a gym because the pain levels start quickly and they don’t subside. However, you could use hydrotherapy as an option because it’ gentle on the body.

I’d also recommend starting a diary to plan your weeks according to treatment, recovery, relaxation and wellbeing. For example, head to the physio on Monday, mark in hydrotherapy for Tuesdays and Friday and so on. And as you progress adjust activity levels to help overcome the pain.

It’s important to note that chronic pain can be overcome with a multidisciplinary approach: physio, GP, personal trainer, dietitian, psychologist.

First published on January 1, 2021.