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The role of exercise in managing persistent pain

Provided by Exercise Right

Regular exercise and movement play a crucial role in managing persistent pain.

Research and healthcare professionals recognise that increasing physical activity levels can improve pain, function, and overall well-being for various persistent pain conditions, including:

  • osteoarthritis
  • back and neck pain
  • shoulder pain
  • fibromyalgia
  • post-surgery pain.

While exercise is recommended for individuals with persistent pain, it can be challenging to start when someone has been experiencing pain for an extended period.

Physical activity and everyday movements may become more painful, and flare-ups can become more frequent and severe. This can diminish confidence, promote anxiety or fear regarding exercise and activity, and ultimately lead to exercise avoidance, which further exacerbates pain.

However, the good news is that learning to exercise in a way that suits your individual needs can have a positive impact on the pain system.

As exercise tolerance increases, pain sensitisation decreases, resulting in fewer and less severe flare-ups as the system becomes less sensitive.


Many people believe that the benefits of exercise for persistent pain primarily involve improved muscle strength, endurance, joint lubrication, and flexibility.

However, regular exercise and physical activity induce multiple positive changes in the body’s systems. This includes the cardiovascular system, brain and nervous system, hormonal system, and immune system.

Exercise can counteract some of the negative effects of persistent pain, such as a weakened immune system, reduced fitness, strength, and resilience, as well as negative impacts on mood.

The combined effect of these system changes can be highly beneficial for individuals with persistent pain.


Exercise offers several health benefits for people with persistent pain, including:

  1. Improved sleep: poor sleep is often associated with higher levels of pain in individuals with persistent pain. Exercise helps regulate the fight or flight response, calming the nervous system and promoting relaxation, leading to improved sleep quality.
  2. Enhanced mood and reduced stress and anxiety: exercise improves the release and responsiveness to naturally produced “feel-good” hormones and neurotransmitters, such as dopamine. This can reduce the perception of pain and have similar effects to some commonly prescribed pain medications, potentially reducing dependency on pain medication.
  3. Increased pain tolerance and desensitisation: even a short bout of exercise, such as a brisk 20-minute walk, can temporarily decrease pain for 20-30 minutes post-exercise. Regular daily exercise can increase pain tolerance and assist in re-engaging in activities that were ceased or limited due to pain.
  4. Improved immune function: exercise reduces systemic inflammation through improved circulation and changes in immune system function. This reduction in inflammation can alleviate pain and low mood, which are often present in many chronic conditions.

Exercise is an effective and beneficial treatment for persistent pain due to the multiple positive changes it brings to the body, brain, and nervous system, resulting in improved physical and psychological well-being.

Additionally, exercise and physical activity can be safe alternatives that minimize potential harm and side effects associated with certain medications and medical procedures commonly used to treat persistent pain.


If you are living with chronic pain, it is crucial to seek appropriate advice when it comes to exercise.

Speak to your GP, Physiotherapist or an Accredited Exercise Physiologist about exercise tailored to your specific needs and goals.

Last updated: October 18, 2023 at: 9:01 am