“Physical Activity in Chronic Pain: What Clinicians Need to Know” is part of a series of six Integrative Health tools designed to assist clinicians who want to enhance patient’s chronic pain self-management skills.  For additional information, refer to the other materials in the “Self-Management of Chronic Pain” overview.

Chronic pain is complex, but it can help to view it from the Integrative Health perspective.  Chronic pain requires day-to-day management through the use of multiple self-care strategies, including setting realistic goals, pacing activity, managing thoughts and feelings associated with pain, and—no less important—moving the body.  This clinical tool focuses how physical activity is important in the self-management of chronic pain and how clinicians can help patients make optimal use of this area of proactive self-care.

Why Encourage Patients with Pain to Continue to Work Their Bodies?

For chronic pain, physical activity is an important part of a self-management regimen that increases active coping.  Treatment approaches that focus on increasing activity rather than avoiding activity have better outcomes.¹

Gradual, progressive exercise improves mood in people who have chronic pain with associated depression or anxiety. For example, in studies of fibromyalgia patients, exercise not only increased fitness and function but also improved their sense of overall well-being.^2,3

Exercise has a positive, albeit modest, effect on pain. Among organizations in the fields of pain and spinal disorders (e.g. North American Spine Society, American Pain Society) exercise is uniformly recommended for problems such as subacute and chronic back pain. A longitudinal population-based study suggests that exercise is associated with lower levels of pain and that less pain is reported during times that more exercise was reported. ⁴

Exercise may have a pain relieving (hypoalgesic) effect.^5-8 In a meta-analytic review, the beneficial effect of exercise was present for individuals who had more localized pain conditions. This did not occur in individuals with diffuse pain. Although more data is needed, exercise may be pain relieving to individuals with fibromyalgia syndrome when exercising at low-to-moderate intensity.⁹