<img src = "https://media.npr.org/assets/img/2017/08/31/padula_npr_sedentary_final_resized_sq-0cba7c0ba67015a68fe462458d454378b80533f1-s100-c15.jpg" data-original = "https: //media.npr .org / assets / img / 2017/08/31 / padula_npr_sedentary_final_resized_sq-0cba7c0ba67015a68fe462458d454378b80533f1-s100.jpg "class =" img lazyOnLoad "alt =" Get out of the couch around the age of 40 with arthritis in both knees, a painful swelling Fortunately, she worked at the University of North Carolina's Thurston Arthritis Research Center, and the woman working in the cubicle next to her ran a program that involved people with osteoarthritis encouraged to begin walking to relieve her pain.
Dehn was skeptical, but too young to be burdened by the disease, and she agreed to try brisk walks. At first she felt stiff, tired and out of breath. That changed quickly.
"I mean, after a few days, I started to feel looser in my joints," she says. "I was not so out of breath and my mood started to improve."
It started with walks of 15 to 20 minutes; Today, Dehne walks about 40 minutes five times a week. She feels great in nature, breathing fresh air, taking in the landscape and talking to her neighbors. As for her knees?
"My knees feel like they were in my youth," says Dehne. "You do not hurt me anymore." And stairs? No problem. "I look up at them and say: 'Oh yeah, that's alright, I can do that – I can go to the third floor of my building."
It may be hard to believe That walking with a painful joint can actually help alleviate the pain. Exercise relieves pain and damage from osteoarthritis in many ways.
On the advice of a co-worker, Dehne participated in a six-week program in which she learned how to be safe to relieve the pain. Now Dehne goes several times a week to train and enjoy. Her knees, she says, "do not hurt me anymore."
Eamon Queeney for NPR
Eamon Queeney for NPR
On the advice of a co-worker, Dehne participated in a six-week program in which she learned how to be safe in order to relieve her pain. Now Dehne goes several times a week to train and enjoy. Her knees, she says, "do not hurt me anymore."
Eamon Queeney for NPR
For the beginning, the structure of the surrounding muscles helps to stabilize the injured joint and increase the lubrication of the cartilage.
"Exercise is essential for the nutrition of the cartilage," says dr. Virginia Byers Kraus, a professor at the Duke University Molecular Physiological Institute, which works in the research and medical committees of the Arthritis Foundation.
"Cartilage has no blood supply, but living cells," she explains. "The way it gets food is a dynamic movement – the weight is moved back and forth as you walk and move, the fluid in the joint flows in and out of the cartilage like a sponge, so all the nutrients in the synovial fluid Cartilage gets into the cartilage and helps to slow it down.
Neuroscientist Benedict Kolber of Duquesne University in Pittsburgh says that exercise can also cause changes in the brain that make a huge difference in pain reduction.
"So our bodies make opioids and use these opioids to relieve pain."
In addition to other mechanisms under development, it is believed that natural opioids bind to the same receptors in the brain as opioid analgesics. Kolber says, but without complications or addictive potential. "There are some circumstances," he says, "under which your body can produce so much of these natural opioids that you actually get a sense of euphoria" – hence the term runner's high, a phenomenon that athletes have since have long described.
Kolber says that exercise also activates parts of the brain that are involved in reducing pain. "We get pain signals that come from our hands to our spinal cord and to our brain," he says, "and then we get those control systems – parts of our brain that seem to be activated when they move – and then spin." relieve the pain system.
And finally, says Kolber, exercise also seems to relieve stress, and stress can increase people's sensitivity to pain.
Dehn's initial reluctance to start walking is explained by sports physiologist Kirsten Ambrose, program manager of the Osteoarthritis Action Alliance at the University of North Carolina, typical of arthritis patients.
"Chronic pain is debilitating and many people do not want to be physically active," Ambrose says, "because they fear it will aggravate their pain or further damage their joints . "
Ambrose tells the patients This gentle physical activity, which is gradually increased with the tailor-made guidance of a health care provider, will indeed relieve their pain and they will have to" think about how to treat them – something in which they can participate safely and comfortably. "
Ambrose Add aloud A number of factors are contributing, including improving sleep quality, improving mood, and reducing depression and anxiety. Sport can "simply increase self-efficacy or belief in the ability to be physically active," she says. And this increased self-confidence can also help relieve pain.
Walking for exercise is not the only remedy, of course, but it is a simple and accessible form of physical activity. "You just need a pair of shoes and a safe place and let's go!" Ambrose says.
And she says most people who try it get relief. After exercising routinely for a while, their pain subsides and they are motivated to keep going.
"People tell us all along that as soon as they start exercising and getting the benefits, they get very involved in routine exercise "says Marcy O & Koon of the Arthritis Foundation.
Back in his lab, neuroscientist Kolber wanted to know if the duration of the workout made a difference in the level of relief for patients. Could an increase in exercise level or "dose" bring more relief?
"Anyone who develops a drug has to undergo hundreds of different dose-related tests," says Kolber, "but during training, there's almost no data on that dose – especially in the context of pain."
So He recently conducted a small, one-week study measuring the sensitivity to pain of 40 healthy women before and after exercise, using heat and pressure to develop pain. The subjects were asked to walk on a treadmill for 30 minutes. Some trained three times this week, others five or ten times.
He and his team found that those who only went three times a week had no difference in pain perception after exercise. For those who trained five or more times a week, however, the results were very different.
"We asked her to rate this pain," he says. "And at the end of the study, they rated the same pressure – the same pressure – as 60% less painful than at the beginning of the study."
So, if you want to try to relieve your pain, do not just do it once or twice and stop, advises Kolber. Shoot at least five times a week after getting out.
A word of caution: The motion physiologist Ambrose recommends slowly starting pain. "It's best to start with small pieces and get on slowly."
She suggests going to Walk With Ease, an Arthritis Foundation-sponsored walking program. It provides resources, offers lessons across the country, and provides tips on when and how to stretch.
"It's structured and gives people very clear guidance on how to start exactly and how to set goals and how to track their progress so they can learn to walk safely and comfortably and take advantage of their arthritis symptoms to use, "she says. The idea is to make walking a "habit".