Over the last decade numerous studies have been done regarding chronic pain and the importance of exercise. Universities and medical research centers alike have proven that regular exercise is a key element in managing the symptoms of many pain-inducing illnesses such as Rheumatoid Arthritis (RA), Fibromyalgia (FMS) and Chronic Fatigue Syndrome (CFS).

The problem is – how does one go about getting any exercise, let alone enough, when they are plagued with pain and fatigue 24 hours a day? While there are no easy answers to this question, there are tools and strategies available – for every budget – that can make exercise possible.

The first piece of advice I give to anyone facing life changes is, whenever possible, don’t start or change too many things at once. One step at a time is usually the best bet. For example, I applaud anyone who wishes to give up soda pop, quit smoking and join a gym but I don’t think all three should happen in the same week, or even the same month necessarily.

Instead, start slow and be realistic when setting your goals, especially when it comes to exercise. Heading to the gym and jumping on the first machine you see is not the best way to get started and you could very easily end up hurting yourself.

Setting realistic goals can be more challenging that it seems we all like to think that we can do “whatever we set our minds to” but that’s not always the healthiest approach. If you could run 5 miles in college every morning but haven’t ran in 25 years, setting a goal of five miles a day right from the start is a poor choice that will undoubtedly end in tears, if not worse.

A more sensible approach would be to start by doing 10 minutes of stretching every morning for a few weeks. Then after you are used to waking up and stretching each morning add in a short walk after your stretching sessions, then a longer walk, then a short jog, etcetera.

If you’re not sure where to begin as far as learning a proper warm-up routine, finding strength training exercises or trying something new like yoga there are now a multitude of free or very inexpensive options available to help you get started.

One of my personal favorites, which is 100% free, is Sparkpeople.com ( http://www.sparkpeople.com ) where you can find short instructional videos, keep track of your exercise, your diet and meet all sorts of awesome people who are all working hard at being as healthy as possible.

Additionally there are now thousands of exercise videos, ranging from 5 to 50 dollars on the market that show you how to do yoga, Pilates, belly dancing, Tai Chi and a variety of other fun and healthful exercise options in the privacy of your own home.

Another option is to search your local Craigslist listings or Freecycle.org listings and find free or low cost exercise equipment that others have given up on. I found my exercise bike, which I use weekly, three years ago on freecycle.org it’s about 10 years old, was gently used and was free – still works great.

If you’ve got money to spare I strongly advocate the Nintendo Wii-fit system. It’s ideal for chronically ill folks because it shows you step by step what to do, will monitor your progress and is fairly engaging for any age. You have the option of doing traditional yoga and strength training exercises, or playing games that work your body – regardless it’s a fun way to get into the habit of exercising and to begin training your muscles for more intense exercises.

Starting slow is the best way and makes it pretty easy to get going. Lay some canned goods around the house and a few times a day, pick them up and do some arm exercises – 1 set of 10 twice a day. Put the exercise bike/treadmill/whatever in front of the TV, turn on your favorite brand of digital crack and set a goal of five minutes to start, or even three if you’re really concerned about not making it. Try that a few times each day, or every other day, and before long, 5 minutes will be easier and you can go for 10 minutes and you’ll be doing 2 sets of 10 on arm exercises. Laying on the bed reading? Turn on your side and do a few leg lifts, then the other side… read a few chapters and do it again. Much like pennies in a jar, after time, it all adds up!

Before you begin any exercise program you should make an appointment with your health care providers and go over your exercise plans and goals with them. Your doctor will know what your body can and cannot handle and can give you advice on what kinds of exercise might be best for your body type and physical issues, such as swimming for FMS and RA.

An important part of reaching any goal is to remember the rewards! I don’t just mean the better health, less pain, more energy stuff – which is a great reward – no I mean the figurative, or literal, gold stars that we earn as we go, the things we do just for us to keep us motivated and moving forward. A new  healthy snack, that pretty blouse in the shop across from where you get groceries, new panties to fit your better toned body, whatever little thing will make you happy and cheer you on to meet the next goal.

Sharing your goals with others is another important step on the path to success, not only can you build up your own cheerleading team, you can likely find folks who will exercise with you, which makes the whole thing a lot more fun! Exercise is one of those more the merrier situations for many and it’s a lot easier to stay motivated when you are working with friends who will both cheer you on and call you out if they think you’re slacking off!

Regardless of what kind of exercise ultimately works for you the most important part is to get started, take those vital first steps toward reducing your pain and fatigue symptoms and taking charge of your health. Good luck!