Balancing Chronic Pain with Heart Health

Updated:Apr 3,2014

Chronic Pain and Exercise GraphicIf you’re a heart disease or stroke patient who also struggles with chronic pain, balancing debilitating or exhausting symptoms with protecting your heart health can seem overwhelming.

Managing the needs of both conditions requires a strong commitment to lifestyle changes, including diet and exercise, attention to prescribed medication and careful communication with your healthcare providers, said Robert Bonow, M.D., a professor of cardiology at Northwestern University Medical School.

Being patient with your body as it heals, or with chronic pain gets under control, is important, but it doesn’t mean you can ignore protecting your risks for heart disease or stroke.

Dr. Bonow, who is also a past president of the American Heart Association, said it’s crucial that even patients with chronic pain find a way to exercise regularly.

“Find the most comfortable way of exercise for you,” Dr. Bonow said.

He suggests looking for different ways to get exercise to find what feels right for your body. For example, you may want to trade high-impact activities such as jogging for exercises that are less jarring such as cycling, walking, strength-training or swimming as your body heals. Runners may try jogging in a pool to decrease the impact on their body.

There are mild yoga techniques that can be taught by a physical therapist or yoga instructor that can not only help you keep you moving during your healing process, but also help relieve stress that you might be feeling during that process.

Tai Chi is also often a recommended treatment for people with mobility challenges and post-surgery activity limitations.

“You can even do exercises while laying on your back,” Dr. Bonow said. “Anything that increases aerobic activity is beneficial.”

Is medication an option?

Use of prescription and over-the-counter drugs is an important discussion for patients and their healthcare providers.

There are different types of anti-inflammatory medications. Non-steroidal anti-inflammatory drugs (NSAIDs) include over-the-counter medicines such as ibuprofen and naproxen, and prescription drugs such as Celebrex (celecoxib). However, taking these can increase risk for heart attack, so they are often avoided by heart patients. Other medications may cause the body to retain water, which can aggravate hypertension, also called high blood pressure, or lead to heart failure.

But if taking those medications means a patient can keep moving, the cardiovascular risks can be outweighed by the health benefits of exercise, Dr. Bonow said. If pain medication is needed, consult with your doctor to manage the risks, starting with drugs that carry the lowest risks.

Patients should also consult their healthcare providers before using dietary supplements. Supplements lack the regulatory scrutiny of prescription medications and may have unintended interactions with medication or side effects that can put your heart health at risk, Dr. Bonow said.

“Make sure your pain management doctor knows if you are also on heart or stroke medication,” he said.

Get the Support You Need

Maintaining a healthy weight through a heart-healthy diet is also a key part of protecting your heart. While chronic pain may increase your appetite or your stress level, heart disease and stroke patients should stick to foods that are low in salt and saturated fats, and favor lean meats, vegetables, fruit and whole grains.

“People sometimes overindulge, or turn to sweets because it’s emotionally soothing,” Dr. Bonow said.

Feeling frustrated or depressed about your condition is understandable. As challenges arise, keep in contact with your healthcare provider, Dr. Bonow said. It's also imporant to manage stress, especially if stress causes you to do things that are bad for your heart health, including smoking, not getting enough sleep, avoiding regular exercise or eating unhealthy foods.

Find a supportive environment that will help keep you motivated to keep up exercise and diet while you’re managing other conditions, whether that’s a support group, loved ones or a class in your own community or recommended by your healthcare provider.

“Try to find something that works for you,” he said. “There’s no ‘one size fits all’ here.”

Learn more:

Cardiovascular Conditions

Sign up for our monthly e-newsletter

Choose at least one