Exercise and Pain

Clinical Expertise

Sep 29, 2020

Medical Reviewer: Anita Davis, PT, DPT, OCS
Last Updated: September 28, 2020

Exercise and pain may not seem to go together, but there are good reasons why therapists and physicians recommend exercise for those who deal with ongoing pain. Here’s just a quick view of the recommendations and rationale:


  1. Stimulating circulation: At the heart of the matter is – the heart. As we exercise, the heart has to increase the blood flow to meet the demands of the muscles. When circulation is pumped into a guarded, painful muscle, better perfusion and exchange of metabolites can happen. Increasing healthy circulation and oxygenated blood can decrease pain related to the buildup of waste products and create a healthier muscle.

  3. Improving mobility: By moving our joints, we stimulate the cartilage to produce the fluid that keeps the joint healthy. Without this fluid (synovial fluid) the joint becomes stiffer. The ultimate example is being in a cast. When healing has completed and the case is removed, people often notice a loss of mobility that may take the assistance of physical therapy to recover. So for those with difficulty moving from pain – it would be doubly hard to move with added stiffness.

  5. Facilitating strength: This is no surprise. It takes movement to stimulate the muscles to develop more strength. Some may find that movement from exercise in a gym, activities at home or even playing for fun. But just like the issue with mobility, when we stay still too long we find a decrease in strength that then adds to the work of basic movements. Think of the last time you were ill and had to stay in bed for a few days. Once you recovered you were not only weak from the illness but those days in bed allowed muscles to become up to 30% weaker.

  7. Improving memory: Take a study break and exercise. By increasing circulation, there is a burst of oxygenated blood flow to the brain. There are even indications that new brain cells in the memory part of the brain develop with exercise.

  9. Improving sleep: It really is hard to go to sleep when your body is not physically tired. There is a natural response of fatigue-induced rest that doesn’t happen when the body has not had enough movement during the day. In addition, by looking at brain wave activity, exercise has been shown to facilitate deeper sleep.

  11. Enhancing mood: Regular exercise can help with depression and anxiety. There are natural chemicals that can enhance mood and well-being. These are released into your body with exercise. Meeting goals and accomplishing something positive can also boost your confidence and self-esteem. Plus the activity becomes a positive distraction from pain.

  13. Decreasing pain: Exercise remains the leading intervention for musculoskeletal pain. But the type of exercise activity can vary greatly and range from exertional aerobics to resistance training or even gentle yoga and Tai Chi. Many of the same effects listed above – improved circulation, released endorphins, distraction and improved sleep – all lead to the ultimate goal of reducing pain for some. Some results show that walking 15 minutes a day can begin to make a difference in as little as a week. But a healthy lifestyle that includes exercise has even greater potential impact on managing persistent pain.

Medical Reviewer

Anita Davis, PT, DPT, OCS

Anita has been practicing physical therapy since 1985. She completed residency training in 2007 and received her doctorate in 2009. She holds membership in the American Physical Therapy Association, the Orthopedic Section and Pain Management Special Interest Group, Academy of Integrative Pain Management and American Congress of Rehabilitation Medicine. Chronic pain rehabilitation has been her specialty since 1990.
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