Jan Willem Elte, The Netherlands
Exercising for up to 30 minutes most days may help to relieve pain in patients with cancer or other diseases. This has been shown in a recent study in more than 60,000 people, including 10.651 with a history of cancer.
Study participants who had been diagnosed with cancer and reported moderate to vigorous physical activity for more than 150 minutes per week had 16 % less pain than those with no or less activity. Exercise was particularly helpful for those with moderate to severe pain. The more exercise, the less pain was felt, both for people with and without cancer. There was no relationship between physical activity and analgesic use in people with a history of cancer.
In another Norwegian study the prevalence of chronic pain was 10 – 38 % lower among people who exercised. There are more randomized trials suggesting that exercise could be an effective pain management tool for conditions such as low-back pain, osteoarthritis, myofascial pain and fibromyalgia.
Cancer-related pain may stem from multiple potential causes, such as the tumor itself (nerve compression), but also as a result of treatment, including surgery, radiation, chemotherapy or complications from long-term medications. Some 40 % of patients have chronic pain post cancer diagnosis and it is often underdiagnosed and undertreated.
It is not exactly known how execise modulates pain, but there are theories. The pain threshold could be raised through activation of central inhibitory pathways. Exercise thus could induce chemical changes that alter how much pain the brain’s sensory neurons can detect. Regular exercise can also reduce inflammation and improve blood flow. Psychological factors may be important, exercise may help boost mood and reduce stress, increasing pain tolerance. Physically active people also tend to be more socially active and this in turn may promote physical activity.
It is wise to start low and slow like walking and build slowly from there. New pain should be alarming though. Pain may be a barrier for exercise, therefore physical therapists could be helpful. Emphasizing the benefits of exercise, like the pain relief, may help motivate patients.
Sources:
- Southwick C. This could be a strong weapon for cancer pain (or any pain). Medscape, February 21, 2024.
- Swain CTV et al. Physical activity and pain in people with and without cancer. Cancer. 2024: 1-9. DOI: 10.1002/cncr.35208.