The role of exercise in persistent pain

For a long time, the standard suggestion for persistent pain patients was to rest and be inactive to prevent a flare up of pain. Now, guidelines promote physical activity and evidence-based movement as an important part of the treatment plan for chronic pain.  When people are restricted from the usual activity and exercise, they become more anxious, tired, depressed and with an increase in pain (which is not helpful). Despite this being the guidelines, it can be tricky to get started with an exercise program when you are experiencing pain.


Persistent pain, otherwise known as chronic pain, is generally defined as any pain lasting longer than 3 months or beyond the expected healing time. Persistent pain affects over 3.6million Australians and is the leading cause of disability. 

For persistent pain, exercise plays a role in: 

  • Regulating sleep 
  • Increasing energy levels 
  • Reducing inflammation through supporting the immune system 
  • Influencing mood and mental health (through improved brain function) 
  • Releasing chemicals that can reduce pain 
  • Reducing nervous system sensitisation 
  • Neuroplasticity (creating new neural networks that positively effect pain) 

Our beliefs and attitudes can make a big difference towards how effective an intervention is. It is important to understand that small flare ups can occur when you are increasing your activity and this does not indicate that there is tissue damage taking place. Hurt does not always equal harm. Some of us tend to be ‘avoiders’, which means that when we do a movement and it hurts, then we actively avoid doing that movement again. On the other hand, some of us are ‘persisters’ which is the “no pain no gain” attitude where we ignore the signals our body is telling us and push through regardless of pain. Neither of these attitudes are helpful in managing persistent pain. An Accredited Exercise Physiologist can help you identify when to persist and when to modify your exercise. 

If you are experiencing persistent pain and would like some support with getting back into exercise, please reach out to us. 

Tamika Hassum 

Accredited Exercise Physiologist