8 Tips for Exercising With Chronic Pain

Goal setting and choosing exercise that you enjoy may help you be more physically active when you have chronic pain.
Image Credit: Hiraman/E+/GettyImages

When you're living with chronic pain, a workout may be the last thing you feel like doing. That's because exercising with pain can be tough — even more so if you experience discomfort on a regular basis.

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Chronic pain is pain that lasts for over three months. It can be constant or come and go, and it can happen anywhere in your body, per the Cleveland Clinic. Common sources of chronic pain include:

  • Arthritis or joint pain
  • Back pain
  • Fibromyalgia
  • Headaches and migraines
  • Muscle pain
  • Neck pain

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If you have chronic pain, know that you aren't alone. More than 50 million U.S. adults experience pain on most days or every day, most commonly in the back, hips, knees and feet, according to a February 2022 study in ​Pain.

Indeed, 20.4 percent of adults reported chronic pain and 7.4 percent of adults reported chronic pain that frequently limited their work and life activities in the past three months (referred to as high-impact chronic pain), according to the 2019 National Health Survey from the Centers for Disease Control and Prevention.

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And because chronic pain can get in the way of your normal functioning, sometimes exercise can feel like too much. But even small amounts of movement may help ease or manage your discomfort.

Here, experts share their tips for exercising with chronic pain.

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"It is never a bad idea to check in with a physician prior to starting your exercise program," says Stephen Lawrence Thorp, MD, pain medicine specialist at Northwell Phelps Hospital. "If you have a significant injury that has been limiting you, it can be beneficial to get some imaging done and a thorough physical exam." A doctor can also connect you with a physical therapist to help you incorporate more movement into your life, he says.

Should You Exercise With Chronic Pain?

While it may be tempting to reduce your activity levels in an effort to manage your chronic pain, it may actually be more beneficial to get moving.

Physical activity can help reduce your chronic pain in the following ways, per Utah State University:

  • It builds muscle strength and flexibility
  • It reduces fatigue
  • It reduces pain sensitivity
  • It reduces inflammation

Exercise may also help improve your chronic pain by rewiring how you respond to pain.

"Exercise can change how the brain responds to pain by normalizing the pain signal process and promoting the release of analgesics — [hormones and other compounds that act] as natural pain relievers — that turn off pain signals," Joseph Lipsky, DPT, CSCS, physical therapist at Reload Physical Therapy & Fitness and certified strength and conditioning specialist, tells LIVESTRONG.com.

Similarly, an April 2017 review in ​Cochrane Database of Systematic Reviews​ concluded that exercise can be beneficial to adults with chronic pain by reducing pain severity and improving their physical function and quality of life.

The review also found that exercising, when done safely, posed little risk to people with chronic pain, especially those who feared that physical activity would increase their pain.

How to Exercise With Chronic Pain

If you're able to be physically active and have received guidance from a doctor or physical therapist, exercise can be a tool that helps you lead a fuller life when you have chronic pain.

Follow these expert-recommended tips to help you get moving:

1. Start With Low-intensity Exercise

It's best not to dive right into high-intensity, rigorous exercise, as overdoing physical activity can result in increased pain, per Utah State University. Instead, focus on low-intensity exercise that feels good for your body.

For instance, low-intensity activities like walking or light swimming for 30 minutes every day may help reduce your chronic pain and stress levels, according to the Cleveland Clinic.

You should also start small when trying to increase your activity levels. "When pain becomes chronic, our body's response to movement and activity can change," says Dallas Reynolds, PT, DPT, director of operations support for ATI Physical Therapy. "Things that normally should not be painful can become painful."

"What we want to encourage with chronic pain is starting to create a better relationship with movement, and we start with non-painful movements, as small as they may seem," he says.

2. Challenge Yourself

While you certainly don't want to overexert yourself when exercising with pain, you do want to challenge yourself.

"Challenging yourself doesn't mean being exhausted or lifting tons of weight — it's relative to the individual and what they have been doing," Lipsky says. "When I have clients with chronic pain beginning an exercise routine who haven't exercised in years or months, walking 15 minutes is challenging."

Pushing your boundaries safely can help you get stronger, he says.

3. Set Goals

When you're trying to establish a fitness routine as a person with chronic pain, it's helpful to have clear goals in mind.

"One person's goal may be to get back on the field at a professional level, another's may be to get onto the floor with their grandchildren," Dr. Thorp says. "Once you are clear about what you hope to achieve, you can begin to build out the program to achieve it."

4. Pick Activities You Love

Another key to getting up and moving is to prioritize fun exercises, Lipsky says.

"For example, I have a client who used to run races but suffers from chronic pain. When we first started exercising again, we used to race, but by walking in our gym," he says. "The power of taking the emphasis off of the specific exercise and more on having fun has a higher chance of success."

5. Take Rest Days and Nourish Your Body

Rest days and exercise are complementary.

"Never forget that we are actually breaking down our muscle and tissue while working out, and it's during our rest days that muscle builds back stronger," Dr. Thorp says. "You should be just as serious and disciplined about your rest days as you are on your training days."

Factors like nutrition and sleep also matter. "Proper nutrition, adequate hydration and optimal sleep will make a tremendous difference in your ability to recover from your workouts and reap the benefits," he says.

6. De-Stress

Keeping stress in check, in addition to getting more physical activity, can also help improve your chronic pain.

"Making sure that you also manage your stress is a large part of pain management, as high stress will increase pain," Reynolds says. "On your rest days, it is recommended that you work on stress-management techniques like meditation. This will help you continue to work on your chronic pain even on rest days."

Tip

New to meditation? Try these beginner-friendly tips for how to start meditating, like starting small with five-minute sessions.

7. Modify Exercise to Make It Safe for You

Even minimal movement can be better than no physical activity when you have chronic pain, according to Utah State University.

But you may need to take some precautions to make exercise safer, like:

  • Modifying to reduce the risk of falling
  • Ensuring proper posture
  • Using a range of motion that doesn't increase pain

8. Tailor Your Fitness Routine to Your Type of Pain

You want to make sure that the kinds of exercise you do are right for your specific type of chronic pain.

"For example, stretching and strengthening exercises are helpful for back pain and arthritis," says Yili Huang DO, MBA, board-certified and licensed pain management anesthesiologist and director of the pain management center at Northwell Phelps Hospital.

"Some forms of chronic headaches can be caused by the neck, so stretching and strengthening the areas around the neck may help," he says. "Alternatively, chronic headaches caused by stress or migraines may benefit from stretching and relaxation exercises."

Warning

"If at any point in time you have severe symptoms such as unremitting pain, weakness in your extremities, loss of balance or any other concerning symptoms, you should always seek medical care," Dr. Thorp says.

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