Exercises for Chronic Health Conditions

Exercises for Chronic Health Conditions

Exercise can help prevent many chronic illnesses as well as make it easier to manage health conditions, from diabetes to joint pain.

In terms of prevention, aim for the recommended 150 minutes of exercise, like brisk walking or cycling, each week. Along with eating a healthy diet, this can cut your risk of diabetes by more than a third, plus increase your level of good cholesterol. Exercise also lowers body weight, blood pressure and triglycerides, thus reducing key risk factors for heart disease.

If you’re already managing a chronic illness, exercise may improve symptoms and reduce the amount of medication you need to take. It builds muscle, which helps you move more easily, and reduces stress, which can aggravate many health conditions. Back pain and arthritis improve with the right stretching and exercise plan. If you have diabetes, exercise can improve blood sugar control.

Exercise’s health effects on:

Heart disease: Regular aerobic exercise and interval training in particular are heart-healthy, boosting cardiovascular fitness.

Back pain: Core exercises strengthen the muscles around your spine, creating better support for your spine.

Arthritis: Exercise enhances the muscles that support your joints, making movement easier; it also eases stiffness.

Diabetes: Exercise helps you use insulin more effectively and lower your blood sugar level.

Asthma: Exercise can help control attacks.

If you’re managing an illness and haven’t been active, talk to your doctor about what exercises are safe, any precautions to take, what kind of discomfort is normal, and what are signs to stop, like feeling dizzy, short of breath or chest pain.

Working with your doctor is especially important when you have diabetes. Because exercise can affect blood sugar, you’ll need to take precautions to prevent blood sugar from becoming too low during workouts.

In terms of intensity, start off slow — that means you should be able to talk, but not sing, when working out.

More information

The Cleveland Clinic has detailed tips on exercising with a chronic condition to help you get started safely.

Arthritis Diagnosis

Arthritis Diagnosis

Diagnosing arthritis may be difficult. There are more than 100 different types of arthritis. Many symptoms are similar among the different conditions affecting the joints. Arthritis may be generally categorized into the following groups: degenerative arthritis, inflammatory arthritis, metabolic arthritis, and infectious arthritis. Osteoarthritis (also known as degenerative arthritis) is the most common type. Rheumatoid arthritis and gout are two other more common types. To make an accurate diagnosis, a healthcare provider may need to:

  • Review your medical history and current symptoms.
  • Examine you, paying close attention to your joints.
  • Order laboratory tests, X-rays, and other imaging tests (such as an ultrasound or MRI).
  • Perform an arthrocentesis (the procedure of removing fluid from a joint).

What is involved in reviewing your medical history and your current symptoms?

When reviewing your medical history, your healthcare provider may ask the following questions:

  • Have you had any illnesses or injuries that may explain the pain?
  • Is there a family history of arthritis or other rheumatic diseases?
  • What medication(s) are you currently taking?

Your healthcare provider may also ask:

  • What symptoms are you having? For example, pain, stiffness, difficulty with movement, or swelling.
  • About your pain:
    • Where is it?
    • How long have you had it?
    • When do you have pain and how long does it last?
    • Describe your pain. (Constant, dull, throbbing, stabbing)
    • How intense is it? (on a scale of 1 to 10, with 1 being no pain, and 10, the worst pain)
    • What lessons the pain?
    • What makes it worse?

What is involved in laboratory testing?

In addition to a complete medical history and physical examination, the following are common laboratory tests:

  • Antinuclear antibody. This test measures blood levels of various antibodies, which may be present in persons with some types of arthritis.
  • Arthrocentesis (also called joint aspiration). This is an exam of joint fluid. A thin needle is inserted into the joint. Synovial fluid is removed with a syringe and examined for cell counts, crystal analysis, culture, and other tests.
  • Complement tests. This test measures the level of complement, a group of proteins in the blood. It is used to help diagnose and monitor systemic lupus erythematosus (SLE) and rheumatoid arthritis.
  • Complete blood count. Measures the number of white blood cells, red blood cells, and platelets present in a sample of blood. A low white blood count (leukopenia), low red blood count (anemia), or low platelet count (thrombocytopenia) are associated with some forms of arthritis or the medications to treat them.
  • Creatinine. A blood test to monitor for underlying kidney disease.
  • C-reactive protein. This is a protein that is elevated when there is inflammation in the body as in some types of arthritis.
  • Erythrocyte sedimentation rate (also called ESR or sed rate). This measures how quickly red blood cells fall to the bottom of a test tube. It is also elevated when there is inflammation in the body. This occurs in some types of arthritis.
  • Hematocrit (PCV, packed cell volume). Measures the number of red blood cells present in a sample of blood. Low levels of red blood cells (anemia) are common in people with some types of arthritis.
  • Rheumatoid factor. Checks for an antibody that is present in most people with rheumatoid arthritis.
  • Urinalysis. Laboratory examination of urine to check for kidney disease that may be associated with several types of arthritis.
  • Uric acid. It is elevated in gout.

What imaging techniques may be used to diagnose arthritis?

Imaging techniques may give your healthcare provider a clearer picture of what is happening to your joint(s). Imaging techniques may include the following:

  • X-ray. X-rays may show joint changes and bone damage found in some types of arthritis. Other imaging tests may also be done.
  • Ultrasound. Ultrasound uses sound waves (not radiation) to see the quality of synovial tissue, tendons, ligaments, and bones.
  • Magnetic resonance imaging (MRI). MRI images are more detailed than X-rays. They may show damage to joints, including muscles, ligaments, and cartilage.
  • Arthroscopy. This procedure uses a thin tube containing a light and camera (arthroscope) to look inside the joint. The arthroscope is inserted into the joint through a small incision. Images of the inside of the joint are projected onto a screen. It is used to evaluate any degenerative and/or arthritic changes in the joint; to detect bone diseases and tumors; to determine the cause of bone pain and inflammation, and to treat certain conditions.

Chronic Pain

What is pain?

Pain starts in receptor nerve cells located beneath the skin and in organs throughout the body. When there is an illness, injury, or other type of problem, these receptor cells send messages along nerve pathways to the spinal cord, which then carries the message to the brain. Pain medicine works by reducing or blocking these messages before they reach the brain.

Pain can be anything from a slightly bothersome, such as a mild headache, to something excruciating and emergent, such as the chest pain that accompanies a heart attack, or pain of kidney stones. Pain can be acute, meaning new, subacute, lasting for a few weeks or months, and chronic, when it lasts for more than 3 months.

Chronic pain has been said to be one of the most costly health problem in U.S. Increased medical expenses, lost income, lost productivity, compensation payments, and legal charges are some of the negative economic consequences of chronic pain. Consider the following:

  • Low back pain is one of the most significant health problems. Back pain is a common cause of activity limitation in adults.
  • Cancer pain affects the majority of people with intermediate or advanced stages of cancer.
  • Arthritis pain affects more than 50 million Americans each year.
  • Headaches affect millions of U.S. adults. Some of the most common types of chronic headaches are migraines, cluster headaches, and tension headaches.
  • Other pain disorders such as the neuralgias and neuropathies that affect nerves throughout the body, pain due to damage to the central nervous system (the brain and spinal cord), as well as pain where no physical cause can be found–psychogenic pain–increase the total number of reported cases.

What are the different types of pain?

Two types of pain include the following:

  • Acute pain. This pain may come from inflammation, tissue damage, injury, illness, or recent surgery. It is of short duration, usually lasting less than a week or two. The pain usually ends after the underlying cause is treated or has been resolved.
  • Chronic pain. Pain that persists for months or even years.

What is chronic pain?

Chronic pain is long standing pain that persists beyond the usual recovery period or occurs along with a chronic health condition, such as arthritis. Chronic pain may be “on” and “off” or continuous. It may affect people to the point that they can’t work, eat properly, participate in physical activity, or enjoy life.

Chronic pain is considered a major medical condition that can and should be treated.

What causes chronic pain?

There are many causes of chronic pain. It may have started from an illness or injury, from which you may have long since recovered from, but pain remained. Or there may be an ongoing cause of pain, such as arthritis or cancer. Many people suffer chronic pain in the absence of any past injury or evidence of illness.

What is the “terrible triad?”

When pain becomes such a problem that it interferes with your life’s work and normal activities, you may become the victim of a vicious circle. Pain may cause you to become preoccupied with the pain, depressed, and irritable. Depression and irritability often leads to insomnia and weariness, leading to more irritability, depression, and pain. This state is called the “terrible triad” of suffering, sleeplessness, and sadness. The urge to stop the pain can make some people drug-dependent, and may drive others to have repeated surgeries, or resort to questionable treatments. The situation can often be as hard on the family as it is on the one suffering with the pain.

How is chronic pain treated?

Chronic pain involves all aspects of your life. The most effective treatment includes symptom relief and support. A multidisciplinary approach to pain management is often required to provide the needed interventions to help manage the pain. Pain management programs are usually conducted on an outpatient basis. Many skilled professionals are part of the pain management rehabilitation team, including any or all of the following:

  • Neurologists/neurosurgeons
  • Orthopedists/orthopedic surgeons
  • Anesthesiologists
  • Oncologists
  • Physiatrists
  • Nurses
  • Physical therapists
  • Occupational therapists
  • Psychologists/psychiatrists
  • Social workers
  • Case managers
  • Vocational counselors

Special pain programs are located in many hospitals, rehabilitation facilities, and pain clinics.

The pain management rehabilitation program

A pain management rehabilitation program is designed to meet your individual needs. The program will depend on the specific type of pain, disease, or condition. Active involvement by you and your family is vital to the success of the program.

The goal of pain management programs is to help you return to the highest level of function and independence possible, while improving the overall quality of life–physically, emotionally and socially. Pain management techniques assist in reducing your suffering.

To help reach these goals, pain management programs may include the following:

  • Medical management of chronic pain, including medicine management:
    • Over-the-counter (OTC) medicines may include nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, or acetaminophen.
    • Prescription pain medicines, including opioids, may be needed to provide stronger pain relief than aspirin. However, these drugs are reserved for more severe types of pain, as they have some potential for abuse and may have unpleasant and potentially very dangerous side effects.
    • Prescription antidepressants can help some people. This is because these medicines increase the supply of the naturally produced neurotransmitters, serotonin and norepinephrine. Serotonin has been found to be an important part of a pain-controlling pathway in the brain.
  • Heat and cold treatments to reduce the stiffness and pain, especially with joint disorders such as arthritis
  • Physical and occupational therapy interventions such as massage and whirlpool treatments
  • Exercise to reduce spasticity, joint contractures, joint inflammation, spinal alignment problems, or muscle weakening and shrinking to prevent further problems
  • Local electrical stimulation involving application(s) of brief pulses of electricity to nerve endings under the skin to provide pain relief
  • Injection therapies, such as epidural steroid injection
  • Emotional and psychological support for pain, which may include the following:
    • Psychotherapy and group therapy
    • Stress management
    • Relaxation training
    • Meditation
    • Hypnosis
    • Biofeedback
    • Behavior changes

The philosophy common to all of these varied psychological approaches is the belief that you can do something on your own to control pain, including changing your attitudes, the perception of being a victim, feelings, or behaviors associated with pain, or understanding how unconscious forces and past events have contributed to pain.

  • Patient and family education and counseling
  • Alternative medicine and therapy treatments, as appropriate

In addition, treatment may include:

  • Surgery. Surgery may be considered for chronic pain. Surgery can bring release from pain, but may also destroy other sensations as well, or become the source of new pain. Relief is not necessarily permanent, and pain may return. There are a variety of operations to relieve pain. Consult your doctor or more information.
  • Acupuncture. Acupuncture is a 2000-year-old Chinese technique of inserting fine needles under the skin at selected points in the body, and has shown some promise in the treatment of chronic pain. Needles are manipulated by the practitioner to produce pain relief.

Chronic Pain

What is pain?

Pain starts in receptor nerve cells located beneath the skin and in organs throughout the body. When there is an illness, injury, or other type of problem, these receptor cells send messages along nerve pathways to the spinal cord, which then carries the message to the brain. Pain medicine works by reducing or blocking these messages before they reach the brain.

Pain can be anything from a slightly bothersome, such as a mild headache, to something excruciating and emergent, such as the chest pain that accompanies a heart attack, or pain of kidney stones. Pain can be acute, meaning new, subacute, lasting for a few weeks or months, and chronic, when it lasts for more than 3 months.

Chronic pain has been said to be one of the most costly health problem in U.S. Increased medical expenses, lost income, lost productivity, compensation payments, and legal charges are some of the negative economic consequences of chronic pain. Consider the following:

  • Low back pain is one of the most significant health problems. Back pain is a common cause of activity limitation in adults.
  • Cancer pain affects the majority of people with intermediate or advanced stages of cancer.
  • Arthritis pain affects more than 50 million Americans each year.
  • Headaches affect millions of U.S. adults. Some of the most common types of chronic headaches are migraines, cluster headaches, and tension headaches.
  • Other pain disorders such as the neuralgias and neuropathies that affect nerves throughout the body, pain due to damage to the central nervous system (the brain and spinal cord), as well as pain where no physical cause can be found–psychogenic pain–increase the total number of reported cases.

What are the different types of pain?

Two types of pain include the following:

  • Acute pain. This pain may come from inflammation, tissue damage, injury, illness, or recent surgery. It is of short duration, usually lasting less than a week or two. The pain usually ends after the underlying cause is treated or has been resolved.
  • Chronic pain. Pain that persists for months or even years.

What is chronic pain?

Chronic pain is long standing pain that persists beyond the usual recovery period or occurs along with a chronic health condition, such as arthritis. Chronic pain may be “on” and “off” or continuous. It may affect people to the point that they can’t work, eat properly, participate in physical activity, or enjoy life.

Chronic pain is considered a major medical condition that can and should be treated.

What causes chronic pain?

There are many causes of chronic pain. It may have started from an illness or injury, from which you may have long since recovered from, but pain remained. Or there may be an ongoing cause of pain, such as arthritis or cancer. Many people suffer chronic pain in the absence of any past injury or evidence of illness.

What is the “terrible triad?”

When pain becomes such a problem that it interferes with your life’s work and normal activities, you may become the victim of a vicious circle. Pain may cause you to become preoccupied with the pain, depressed, and irritable. Depression and irritability often leads to insomnia and weariness, leading to more irritability, depression, and pain. This state is called the “terrible triad” of suffering, sleeplessness, and sadness. The urge to stop the pain can make some people drug-dependent, and may drive others to have repeated surgeries, or resort to questionable treatments. The situation can often be as hard on the family as it is on the one suffering with the pain.

How is chronic pain treated?

Chronic pain involves all aspects of your life. The most effective treatment includes symptom relief and support. A multidisciplinary approach to pain management is often required to provide the needed interventions to help manage the pain. Pain management programs are usually conducted on an outpatient basis. Many skilled professionals are part of the pain management rehabilitation team, including any or all of the following:

  • Neurologists/neurosurgeons
  • Orthopedists/orthopedic surgeons
  • Anesthesiologists
  • Oncologists
  • Physiatrists
  • Nurses
  • Physical therapists
  • Occupational therapists
  • Psychologists/psychiatrists
  • Social workers
  • Case managers
  • Vocational counselors

Special pain programs are located in many hospitals, rehabilitation facilities, and pain clinics.

The pain management rehabilitation program

A pain management rehabilitation program is designed to meet your individual needs. The program will depend on the specific type of pain, disease, or condition. Active involvement by you and your family is vital to the success of the program.

The goal of pain management programs is to help you return to the highest level of function and independence possible, while improving the overall quality of life–physically, emotionally and socially. Pain management techniques assist in reducing your suffering.

To help reach these goals, pain management programs may include the following:

  • Medical management of chronic pain, including medicine management:
    • Over-the-counter (OTC) medicines may include nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, or acetaminophen.
    • Prescription pain medicines, including opioids, may be needed to provide stronger pain relief than aspirin. However, these drugs are reserved for more severe types of pain, as they have some potential for abuse and may have unpleasant and potentially very dangerous side effects.
    • Prescription antidepressants can help some people. This is because these medicines increase the supply of the naturally produced neurotransmitters, serotonin and norepinephrine. Serotonin has been found to be an important part of a pain-controlling pathway in the brain.
  • Heat and cold treatments to reduce the stiffness and pain, especially with joint disorders such as arthritis
  • Physical and occupational therapy interventions such as massage and whirlpool treatments
  • Exercise to reduce spasticity, joint contractures, joint inflammation, spinal alignment problems, or muscle weakening and shrinking to prevent further problems
  • Local electrical stimulation involving application(s) of brief pulses of electricity to nerve endings under the skin to provide pain relief
  • Injection therapies, such as epidural steroid injection
  • Emotional and psychological support for pain, which may include the following:
    • Psychotherapy and group therapy
    • Stress management
    • Relaxation training
    • Meditation
    • Hypnosis
    • Biofeedback
    • Behavior changes

The philosophy common to all of these varied psychological approaches is the belief that you can do something on your own to control pain, including changing your attitudes, the perception of being a victim, feelings, or behaviors associated with pain, or understanding how unconscious forces and past events have contributed to pain.

  • Patient and family education and counseling
  • Alternative medicine and therapy treatments, as appropriate

In addition, treatment may include:

  • Surgery. Surgery may be considered for chronic pain. Surgery can bring release from pain, but may also destroy other sensations as well, or become the source of new pain. Relief is not necessarily permanent, and pain may return. There are a variety of operations to relieve pain. Consult your doctor or more information.
  • Acupuncture. Acupuncture is a 2000-year-old Chinese technique of inserting fine needles under the skin at selected points in the body, and has shown some promise in the treatment of chronic pain. Needles are manipulated by the practitioner to produce pain relief.
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