How to Improve the Relationship Between Physical and Mental Health

Chris Vi, PhD Candidate (Medicine), B.H&MedSci(Hons), B.BioMedSci

Deeya Mahadooa, MSc Mental Health Psychology, BA(Hons) Psychology 

 

How can this relationship be improved?

Address the pain

Manual therapy:
An early systematic review and meta-analysis also found that massage was more efficacious than other active treatments for pain and anxiety in surgical populations (Boyd et al., 2016).

Massage has been found to improve patient prognosis in populations suffering from both mental health disorders: depression, anxiety, and various pain conditions: breast cancer, fibromyalgia, low back pains or myofascial pain syndrome, and could be used as an efficient treatment option (Rapaport et al., 2018).

Dry needling has also been found to decrease musculoskeletal pain, increase pain threshold, and have positive functional outcomes (Gattie et al., 2017).

What to note: body of evidence is still limited, very few studies consist of large sample populations, and there is no clear assessment criteria for massage therapy practices specific for pain (Miake-Lye et al., 2019). The true efficacy of these therapeutic techniques remains unclear due to varying practitioner skillset, technique, and experience. Therefore, research often produces low to moderate evidence of positive effects. This limits how much can be concluded on the effects, however, there is growing research to support a positive relationship between massage therapy, pain, and mental health.

Additionally, addressing mental health could provide and ensure favourable recovery processes, as decreasing depressive symptoms could improve and influence pain perception (Bushnell et al., 2013; Kellezi et al., 2017). This results in improving not only mental health and physical pain, but also overall quality of life

Exercise:
Although it is tempting to avoid exercise due to pain, this can be counter-productive due to limiting mobility and muscle atrophy which may further exacerbate the condition (Parker et al., 2017).

Aerobic, aquatic/pool exercises, resistance training, yoga, walking, and stationary cycling were noted as beneficial to reducing pain, pain symptoms, and improving physical function (Ambrose & Golightly, 2015).

In populations of people suffering from chronic pain, physical activity demonstrated to be beneficial and as effective as analgesic drugs and NSAIDs in improving pain symptoms (Ambrose & Golightly. 2015). However, ignoring the pain and working through it just for the sake of physical activity can have adverse effects and worsen the condition due to overuse of muscle and joints (Parker et al., 2017).

Regular physical activity is also associated with positive mental health (Biddle, 2016; Jeoung et al., 2013). Changes at physiological and biochemical levels lead to the release of ‘happy’ hormones (dopamine, serotonin, endorphins) which in turn, reduces stress, whilst increasing other positive aspects such as self-esteem, mood, and energy levels (Heijnen et al., 2016; Mikkelsen et al., 2017). Positive effects of physical activity can further be extended to towards stress relief, increased social interaction and self-efficacy, to improve one’s overall well-being (Sharma et al., 2006).

Ortega et al. (2012):
• In fibromyalgia patients, regular exercise, over a period of 4 months or more, demonstrated a decrease in pro-inflammatory markers
• Additional effects were observed in improvements of health-related quality of life: reducing pain, stiffness and fatigue.

Review article by Ambrose & Golightly (2015):
• Compared studies into chronic pain and exercise and demonstrated
• Physical activity can decrease inflammatory markers, associated with systemic (whole body) inflammation, caused by comorbid diseases, which may contribute to chronic pain conditions (such as fibromyalgia)
• Physical activity has beneficial effects on physical function, sleep and psychological disorders amongst chronic pain suffers

Study review:
Burg et al. (2017) examined the relationship between daily stress experience and exercise behaviour in 79 adults.
– Results showed exercise to be a stress reduction for 15 individuals, stress increase for 2, and indifferent for the remaining sampled population.
– Interestingly, 17 participants who experienced more anticipated stress that morning or night before, were 20-22% less likely to exercise.

These findings suggest that certain levels of stress have a significant and, evidently, negative effect on behaviour and likelihood of engaging in physical activity – even if the activity is intended to be a “stress reliever”. It could be implied that there is potentially an optimal level of stress that can positively influence behaviour or act as motivation for exercise.

Important: Stress is normal, an appropriate amount can be deemed functional or beneficial (McEwan, 2017), however, certain levels dysfunctional which negatively influence behaviour. This can be further applied to the rehab process, if your emotional well-being is hindered, your likelihood to engage in exercise, even for rehab purposes, could be negatively affected (Kellezi et al., 2017).

Exposure to, and perception of, stress varies (Keller et al., 2012), working to find out what triggers and maintains negative feelings, and what helps alleviate these, for YOU, this is important for long-term results.

 

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