Gentle Exercise May be More Effective Than Medications at Managing Chronic Pain

With one in five people experiencing some form of chronic pain, it’s a simmering global health problem. Unfortunately, the pharmaceutical solutions come with their own complications, like unequal access, addiction, adverse side effects, and more. And so-called “natural remedies” are unregulated and unreliable. Except for exercise, potentially.

When we exert ourselves, our bodies release endogenous opioids (endorphins) that can relieve pain, increase pain tolerance, and boost our mood. While there are heaps of studies investigating the analgesic effects of exercise, most of them focus on specific conditions (like osteoarthritis) and/or specific exercises (like yoga). Even meta-analyses scrutinizing the link between the two tend to be fairly tight in their focus, which limits their applicability. That’s why a group of pain and exercise experts led by researchers from Adelaide University in Australia teamed up to conduct an umbrella review, or meta-meta-analysis.

Altogether the team examined 158 systematic reviews covering over 2,700 randomized controlled trials involving close to a quarter of a million participants. In other words, this umbrella review has a pretty big umbrella. The goal of the analysis wasn’t just to find out whether exercise relieves pain, but to identify and establish guidelines for prescribing exercise as a treatment, something the researchers say is rarely recommended.

So what did they find?

Exercise can consistently and significantly reduce both acute and chronic pain, and not just for musculoskeletal conditions. Those with neurological, inflammatory, and cancer-related pain saw benefits as well. Exercise was equivalent to a 1.1 reduction in pain on a scale from 1 to 10. While that might not sound like a lot, it’s 60 percent better than pain relief reported from common medications, the researchers say. And if you’re not the most active person, there’s some more good news—shorter, lower-intensity exercise yielded the greatest pain reductions.

“Our study found that exercise was associated with substantial reductions in acute and chronic pain across all forms of exercise‚ whether that be via aerobic or resistance exercise, or through gentler movement such as yoga, Pilates or tai chi,” study author Ben Singh of Adelaide University explained in a statement. “Importantly, we found that more exercise wasn’t necessarily better. In fact, shorter-duration and lower-intensity programs showed greater reductions in pain, suggesting people may not need to exercise harder or for longer to experience meaningful benefits.”

The team hopes these findings will encourage doctors to consider exercise either as alternative to medication or as part of a more comprehensive treatment. “At a time when we’re looking for safe and effective ways to manage pain beyond medication,” added study author Carol Maher, “these findings provide strong evidence for making exercise a more routine part of pain care.”