Coping with Lupus: People with lupus are usually encouraged to engage in appropriate daily exercise to keep up muscle and bone strength. Exercise is not intuitive for those with auto-immune health challenges like lupus, rheumatoid arthritis or fibromyalgia. Waking up each morning with joint stiffness and pain, the first thought on my mind is definitely NOT exercise!
My natural inclination is a long hot tub bath or jacuzzi soak to wrap warm comfort around aching joints, or perhaps sipping coffee in bed while waiting for analgesic and morning prednisone medications to “kick in.”
Exercise? Are you kidding?
Yes, our doctors all tell us (and everyone without auto-immune disease, too) to exercise! Why is the idea so repugnant to us? Simply because we hurt! The idea of moving and getting up to shake up painful joints is simply counter-intuitive. We can’t imagine that when moving hurts, doing more of it will make us hurt less. But, the truth is that moving gently and getting some mild exercise WILL help manage and relieve pain. Trust me, believe your doctor, and if you are not getting any or enough gentle exercise, I urge you to consider starting.
With a membership in a health club, I could swim in an indoor pool — it was invigorating! Some days, I work through some simple yoga exercises that help stimulate my deep breathing and encourage circulation in joints, tendons and cartilage using gentle controlled movement and balance — it is refreshing! Other days, I get on my bike, with its rear wheel nestled in its indoor fluid trainer stand (a normal exercise bicycle works well, too) and spin for as few as ten or as many as 30 minutes – it is strength-building!
What about the bad days?
On days I hurt the worst, I do just a few minutes of the simplest yoga moves or spin on the bike for no more than 10 minutes. The goal is just to stir up a little circulation and get my joints in motion, and to stir up a little adrenaline to get me feeling like moving. Almost always, the gentle movement results in a lowering of my perceived level of pain, and puts my body into a more energetic state.
With a little more adrenaline flowing, and a natural rise in body endorphin levels, my ability to handle the pain increases, and my perception of the pain decreases. It’s just the biology of movement, nothing more. This is the effect of exercise that is so counter-intuitive to the pain. You don’t naturally think it will happen when you feel like stilling still, because every motion of your joints hurts.
Balancing exercise and rest – remember moderation!
Take care to balance exercise with rest or when you hurt. Our doctors rightly tell us not to overdo, or to move in ways that cause more pain. The right amount of exercise, done with moderation and restraint, should help the pain decrease almost immediately when you start moving. Increasing pain means it is time to stop the exercise. Caution to take things slowly is always first when thinking about exercise.
It may take a while to build up to enough exercise to get an aerobic effect. For me, the pain drastically reduces when I reach the aerobic point in my routine. My breathing deepens, my strength suddenly increases and my pain reduces. I first learned to find the aerobic point when I went through physical therapy for a damaged shoulder and rotator cuff.
Magic of crossing the aerobic point
The therapists used computerized equipment that measured the movements and changes in my strength levels during the routines. They would point out the moment when the computer registered the rise in my strength, and I could associate it as a point when I experienced a drop in pain. The bursts of strength would occur several times during the therapy routines, and each time I would feel a little stronger and move more easily.
I sense a response similar to the physical therapy with gentle sustained exercise. My first sense of the change is usually about 12 to 17 minutes into my cycling. After that, I feel like going a little faster, and immediately feel a little more energetic. I usually try to cycle long enough to reach that first point, and push beyond it a little.
Building up, slowly
If I am having a string of days or weeks of quieter lupus, I can build up to about 30 minutes of exercise, never adding more than a minute each day. Some days, if I am hurting a lot, I slowly cycle for only about 5 – 10 minutes, never pushing speed to a point where pain rises. Even moving very slowly helps a little! I cannot remember a time when I didn’t feel at least slightly better after exercise than I did before it.
Try it. Really!