Are Yor Sore After A Days Ride?

Lose Weight to Reduce Your Chronic Pain*

Chronic pain is a devastating condition that affects as many as 90 million Americans. Unlike short-term, acute pain-the kind that happens when you sprain an ankle-chronic pain can last for months, or even years.

        But research has shown that losing excess pounds can help relieve chronic pain. For example, a study published in the December 2010 issue of The Journal of Pain reports that there is a close association between obesity and disability in fibromyalgia patients. And losing weight has also been shown to benefit patients with arthritis of the knee by decreasing stress on the joints.

        “The most effective activity for weight loss is aerobic exercise,” says Catherine Sarkisian, MD, a geriatrician at UCLA Health System, Aerobic activities include running, bicycling, and dancing, but for people with chronic pain, gentler aerobic activities such as walking and swimming can be beneficial. Strength-training exercises that build lean muscle mass also can help, since muscle burns more calories than fat.

        In general, most people are advised to exercise for at least 30 minutes a day, most days of the week, but if you are a chronic pain sufferer, you may need to start slowly. Ask your doctor or pain medicine specialist what types of exercises are right for you, and how often you should be doing them.

Losing weight through diet. If you’re exercising regularly and not losing weight, you need to eat less. “One mistake people make is thinking that because they exercised they can `reward ᷄ themselves by eating more­ an entire hour of vigorous walking can be undone calorie-wise in 10 minutes by a glass of orange juice and a bagel,” Dr. Sarkisian says.

        “Rather than going on a diet, initiate lifelong behavior changes that will result in losing one to two pounds per week until you get to your goal weight,” she advises.

Other risks associated with obesity. It’s important to remember that carrying excess pounds doesn’t just increase your likelihood of having pain. “Being overweight increases hypertension and diabetes, both important risk factors for heart disease,” says Dr. Sarkisian. “In addition, fat cells release proteins (such as interleukins and cytokines) into the bloodstream that accelerate atherosclerosis (hardening and thickening of the arteries).”

        Aim for a body mass index (BMI) below 25, she advises. You don’t need to be rail-thin to achieve this goal. “Someone who is 5 feet 6 inches tall only needs to weigh less than 155 pounds to have a BMI below 25,” Dr. Sarkisian explains. A BMI of 25 to 29.9 is considered overweight, while a BMI of 30 or higher is considered obese (see “What You Can Do” to determine your BMI).

Treatment options for chronic pain. The most common treatment for chronic pain is the use of analgesic medications. Acetaminophen (Tylenol, for example) is the safest analgesic medication for most patients with mild to moderate pain, especially those with arthritis, back pain, headache, or other causes. Acetaminophen, as compared to non-steroidal, anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) or naproxen (Aleve), does not cause stomach problems or kidney damage and usually does not interfere with most other medications or disease processes.

        Opioid drugs, such as codeine (Tylenol No. 3), oxycodone (Oxycontin), hydrocodone (Vicodine), morphine, hydromorphone (Dilaudid), and transderm fentanyl (Durgesic) are often used for more severe pain problems. Although these drugs can cause drowsiness and constipation, and can be habit-forming, they may be essential to control chronic pain that is severe from any cause.

        “We probably don’t use these drugs as often as we should,” says Bruce Ferrell, MD, a geriatrician at UCLA Health System and Editor-in-Chief of UCLA’s Healthy Years. “There is probably an over-concern by many physicians and patients about the potential for addiction using these drugs in high does for long periods of time. In older patients, this fear is often way out of proportion to the actual occurrence of these problems and may be a barrier to their use. In fact, for many patients with chronic pain, opioid drugs may be safer than NSAIDs for long-term use.”

*UCLA School of Medicine