6. Movements: Virtual, Nerve Glides, and Gentle Exercise
Moving properly when informed by pain neuroscience can naturally lower your chronic pain.,, This is because exercising slowly and gently rewires the nervous system’s pain signals, causing them to trigger less often and less potently. Moving this way helps pain caused by a lack of mobility or deconditioning, generates pain-relieving endorphins, and helps the nervous system reach a parasympathetic state where healing takes place. Imagined movements, nerve glides, and other gentle exercises are the beginning of properly exercising with chronic pain and unlocking these benefits.
Imagining movements gives a starting point for even the most severe chronic pain cases. Due to how pain neurotags work, as discussed in part one, imagining moving part of the body can be a critical starting place when pain is too intense from movement. Imagining a movement can activate brain areas usually activated in a pain experience but without causing pain. If even imagining a movement causes pain, a workaround can be to imagine moving part of the body. For an example of how to do this, take the case of an ankle injury. Simply walking or standing could cause too much additional pain, so you could begin to retrain the pain neurotag associated with such pressure by simply imagining standing or walking. You could use the imagined movement as a warmup or even a transition stage to trying those movements physically in the future. There are many ways to use your mind in retraining movements, including imagery, changing the environment associated with a movement, visual cues, or even moving multiple body parts at once to alter your pain responses. These ideas are discussed in my book.
Nerve glides are simple movements that elongate the segments of the peripheral nervous system. Nerves are in every part of the body and can get compressed or shortened after idleness or injury, making them cause pain on their own. Moving and lengthening these nerves can gently stretch the entire neural network throughout the body and relieve that pain. Nerve glides can also be used for areas of the body that have pain, numbness, or tingling. In addition to the pain relief from compression, these gentle movements are a great starting place for exercise to lower your overall baseline level of pain and alter pain thresholds, as seen in the next point about teasing pain. I learned about nerve glides at Dr. Lemons’s clinic and still use them each day to keep my nerves elongated even after the movements no longer lower my baseline pain.
There are nerve glides for many parts of the body, including sciatic, ulnar, radial, and median nerves. Certain nerve glides, such as a sciatic nerve glide in which you kick out a foot and tilt your head, can stretch every nerve from head to toe. Nerve glides are not for building strength but rather for gently mobilizing the body. They are a graceful fluid motion, not a static hold. During a glide, you want to be as relaxed as possible, breathing slowly and rhythmically, and they should not cause pain. If they cause pain, then stop them. As with any exercise when you have chronic pain, you should only aim for a few repetitions and see how your body responds.
For proper instruction and a program using nerve glides personalized to your health context, see a qualified physical therapist. For more information on nerve glides, this article discusses the various kinds of nerve glides and how to perform them.
Other gentle movements can help to lower pain and raise pain thresholds as well as build strength. These include, but are not limited to: walking, Tai Chi, Qi Gong, Yoga, and isometrics (static holds of movements). Some cutting-edge nervous system treatments include mirror boxing, two-point, size, and object discrimination. I have employed nearly all of these approaches in my journey back to robust health. I expand on all of these approaches in my book.
When you have chronic pain, to be successful with any of these movements and virtual movements, you need to implement them with the principle in the next point, the neuroscience of teasing pain.