Struggling with chronic pain from migraine and Idiopathic Intracranial Hypertension (IIH), Laura McKee put exercise near the bottom of her priority list. Nowadays, however, she is a keen swimmer with a renewed motivation to live her best life. Today, Laura shares her journey with exercise and pain management.

It can seem counterintuitive to be physically active when in relentless pain, especially if your pain worsens when you do. As someone living with chronic pain, I know that finding the motivation to exercise is challenging. Still, with professional guidance, gentle activity has helped me manage my pain better.

Doctors often recommend helping yourself to manage chronic pain with exercise and low-impact activity, such as walking, swimming, yoga, or dancing. However, everyone is different, so always check with your healthcare team before starting any new routine.

Regular exercise, little and often, may increase pain tolerance over time and is known to reduce pain sensitivity.

When I was diagnosed with chronic migraine, I continued with Pilates classes. I started yoga, learning to adapt to meet my needs. But when I developed Idiopathic Intracranial Hypertension (IIH), I was in constant extreme pain. This rare but chronic brain condition meant I struggled to leave my bed, let alone do any gentle activity.

Today, I follow my journey from no activity to lying and seated exercises to becoming a regular swimmer. I explore how this has helped manage my pain, the benefits to my well-being, and the challenges I still face.

4 ways regular exercise has affected my daily life with chronic pain

1. My motivation has increased

Migraine and chronic pain often lead to other symptoms, such as limited mobility, brain fog, fatigue, insomnia, mood swings, anxiety, and depression. These can significantly impact someone's quality of life, including the motivation and energy needed to exercise.

When I became stuck in bed due to my IIH, I struggled to walk the few steps to my bathroom. The stress of constant pain diminished my energy and left me anxious and depressed. Exercise went on the back burner, and I wasn’t aware of the impact this was having on my mental health.

According to a National Library of Medicine study, Does exercise increase or decrease pain? Central mechanisms underlying these two phenomena:

"Exercise not only reduces pain perception but also has effects on mental health, such as mood elevation and reduction of stress and depression, which are often associated with chronic pain conditions.”

The mental and physical toll of unyielding pain left me unmotivated. But, over time and with professional guidance, I learned to listen to my body, create achievable goals, and focus on what felt good. I started to feel a genuine drive to take baby steps with exercise.

2. It helps me rise to the challenge

As I realized my bed was where I’d spend most of my time, my Pilates know-how became invaluable. I used adapted exercises in bed to protect my core and build stamina. I listened to my body, and my better days became opportunities to practice gentle movements.

IIH affects my balance, leading to limited mobility. Still, with treatment and my bed exercises, I found on some days, I could move more steadily. Unfortunately, the unpredictability of IIH meant that this was erratic, and being in bed with an IIH or migraine flare-up led to weight gain.

My limited mobility and poor balance led to periods of health setbacks and months when I couldn’t exercise. When I had a trapped nerve, a physiotherapist taught me safe, adapted exercises I could do lying down or seated, motivating me to set a routine. This built my confidence and improved my well-being.

On vacations, I explored my love of swimming to see how it affected my pain. I had mixed results. Surgery meant I had to swim with my face in the water to keep my head and spine in line, but I was nervous because IIH induces severe facial pain. But I kept at it, and on one vacation after my 2019 surgery, I managed to swim successfully.

So, in 2022, when my social worker asked if I'd like support to do something to improve my quality of life, I wished to swim. I was given additional funding for my PA to take me to the pool weekly. I found a quiet, disabled-friendly pool and started gently, as it initially hurt. However, I was motivated to continue.

I built up to 20 lengths of an 18-metre pool, interspersed with my physio exercises, walking lengths, and stopping to chat with my physiotherapy assistant. It was exhausting and increased my pain, so I’d need to take my prescribed pain medication afterward and have help getting dressed.

3. The really bad days with chronic pain are, slowly but surely, becoming fewer

My ability to swim has been hit hard at times due to flare-ups and falls. I had the motivation, so when I couldn't swim due to high pain or injury, I'd feel frustrated. After breaking my foot in a fall soon after taking the plunge, it felt like starting from scratch.

But I did build up my stamina and was swimming 40+ lengths in time, which boosted my mental well-being. This took a major hit when, in early 2023, my poor balance smacked me in the face when I fell, breaking my nose and face. I couldn’t swim for months, leading to disappointment and a lower quality of life.

I listened to my body and set goals to return to the pool once I healed. Sadly, it all came crashing down again when I developed pneumonia and anemia, leading to more than yet another month in bed. These episodes hit me hard, giving my IIH the power over my mind, often leading to unfounded feelings of guilt, as well as depression.

I won’t let this keep me down. I love the freedom of the water, where I can move without the limits of my physical disabilities. I set goals to motivate me, such as swimming a second day with my husband or swimming X number of lengths.

When I notice slight improvements, it spurs me on. My IIH means I’ll always be a bit wobbly on my feet, exhausted, and needing mobility aids. But swimming has enabled me to move around my bedroom without my walker and given me more energy.

I noticed my pain was better controlled, with fewer bad days and shorter recovery periods. Over time, I noted that when my body was sore, but it wasn’t wholly debilitating, I could manage the chronic pain with exercise at my local pool. The tension in my neck and shoulders would melt away as I pushed on with every gentle lap.

Friends have been surprised by how much I’ve improved in my day-to-day life. I’ve set goals to get out of bed most days and go downstairs earlier to be around my family. This has improved connections, fulfillment, and entire well-being.

My current goal is to build on my twice-weekly swims. I want to add a 15-minute morning routine of physio exercises using gentle Pilates and yoga movements, like the warrior pose. I’ve also started online seated yoga sessions to help me develop strength, balance, and flexibility (and also to help balance my mood).

4. Exercise helps me to manage my pain better, leading to a better quality of life

Studies have produced evidence that exercise improves both pain management and physical function.

In her 2021 article for the Economic Times, How to exercise with chronic pain: Two-hour rule, starting small, Gretchen Reynolds says, "Exercise… often reduces feelings of pain immediately afterward and raises people's pain thresholds.”

Likewise, many scientific reviews have shown how low-impact exercise affects the brain's pathways and its role in pain management. Studies often examine the impact of structured exercise on various aspects of an individual's well-being, such as pain intensity, physical and psychological function, and overall quality of life.

For example, Raj N. Sureja, MD, asserts the following in their article, The Relationship between Exercise and the Improvement of Chronic Pain:

"Exercise promotes the release of… endorphins, which act as natural painkillers and enhance pain tolerance. Additionally, regular exercise increases the production of neurotransmitters like serotonin and norepinephrine, which are involved in pain modulation and mood regulation. Exercise also promotes… improved pain coping mechanisms."

Gradual increases in daily activities and gentle exercise, with guidance from a health professional, can reduce hesitancy about worsening pain and prevent damage. I started using my better days to do more and have found that doing a little every day has reduced the frequency of excruciatingly bad days.

There have been so many improvements already!

There are many benefits to building up gentle exercise slowly and being careful not to overdo things on “good” days. These are:

• Strengthened muscles
• Improved balance/stability
• Enhanced flexibility
• Better weight management
• Reduced stress
• Improved mood
• Better sleep quality

Over my fitness journey, I've learned that expert guidance is crucial for success. I rely on professionals such as my doctor, physiotherapists, and trained instructors to help me create a personalized exercise plan that works for my body and condition. Their expertise has reduced the risk of failure, prevented injuries, and given me more control.

Learning to help manage my chronic pain with exercise has improved my mental and physical well-being. I’ve experienced difficulty sticking to a routine due to fall injuries and flare-ups, affecting my willpower. Whenever I recover from a bout of illness, part of me begins to fear the next flare-up, which also affects my motivation.

However, becoming more mobile, having less fallout from doing things that improve my quality of life, and satisfaction from meeting my goals have made the initial pain worth it. I’ll always have challenges, such as my current debilitating pain flare-up. Still, exercise has increased my pain threshold, giving me a more balanced and fulfilling life despite the flare-ups.

The information presented is solely for educational purposes, not as specific advice for the evaluation, management, or treatment of any condition.

The individual(s) who have written and created the content and whose images appear in this article have been paid by Teva Pharmaceuticals for their contributions. This content represents the opinions of the contributor and does not necessarily reflect those of Teva Pharmaceuticals. Similarly, Teva Pharmaceuticals does not review, control, influence, or endorse any content related to the contributor's websites or social media networks. This content is intended for informational and educational purposes and should not be considered medical advice or recommendations. Consult a qualified medical professional for diagnosis and before beginning or changing any treatment regimen.

NPS-ALL-NP-01241 JUNE 2024