Managing Chronic Pain and Exercise

As an accredited exercise physiologist, I have helped a lot of people manage chronic pain with exercise over the last nearly 20 years.  These programs have ranged from improving their quality of life by allowing them to move more to returning to sport.  In that time, I have provided education to clients about chronic pain and exercise.  So this blog is not about what exercises to do, but more about the principles I have taught my clients in regards to chronic pain and exercise.


I cannot stress this enough!  I have had a number of clients referred to me who first had a session with a personal trainer, and then were not able to get out of bed from 3 days to a week.  Also, it is amazing the amount of information we have access to with the click of a button.  Just searching back pain and exercise on the internet will give you a choice of over 51 million webpages!

To get advice about chronic pain and exercise consult an Accredited Exercise Physiologist.  An Accredited Exercise Physiologist can work with your Physiotherapist, Specialist or GP.  With the knowledge of your specific conditions, they will be able to design the best possible exercise program.  Being engaged with an accredited exercise physiologist is important as they will be able to monitor your program and provide you with ongoing support and program modification.


Now I do not need to tell you about pain because you live it every day.  You know your pain!  But not all pain can be bad.  What I’m talking about here is the difference between bad pain and good pain. Good pain I hear you saying?  The ‘good pain’ I’m referring to is the type of pain you might get when you start an exercise program.  This is usually the result of muscle soreness because they have not been used, for sometimes, a long time.  Normally, this ‘good pain’ will go away within 48 hours.  However, if your condition specific pain increases please advise your accredited exercise physiologist.  We are not mind readers!


A number of clients I have seen have come with the attitude of ‘no pain no gain’.  So they begin their exercise program with this motto.  They soon come unstuck because their body does not respond like that with chronic pain and exercise.

Prior to having chronic pain condition, you could push yourself hard when exercising.  The next day or two you would be sore and then you would be fine to do it all again.  But now pushing yourself to the limit of your physical capacity does not have the same consequences.  Now it will likely put you in bed for a couple of days and maybe increase your medication usage.  This will involve a little trial an error to begin with but knowing how far you can push yourself, without going over your threshold of pain, is very important.  Working with an accredited exercise physiologist can help you determine your limit with minimal consequences to your chronic pain.


Self-management is your ability to manage symptoms, physical and social consequences and lifestyle changes that come with living with chronic pain.  This could just be taking your medication but hopefully it included some type of exercise.  It may be light walking, hydrotherapy, Pilates, core strengthening, using heat packs, stretching to name a few things.

Why is having this plan important?   When your symptoms are aggravated it could possibly

  • reduce your symptoms
  • reduce your down time
  • decrease your reliance on pain medication

Why not try to incorporate exercise as part of your self-management? Exercise has a number of other numerous effects on our overall health and well-being that can improve other aspects of your health ie endorphin release which inhibit the transmission of pain signals.


Nearly every chronic pain rehabilitation client that I have seen over the last 20 years has experienced some kind of set back during their rehabilitation program.  Why causes this to happen?  It could be from being too confident and doing something beyond their limits or something simple like bending and twisting to lift an object.

One of the keys here is not to be too discouraged when it does happen.  And certainly do not get too down on yourself either.  Dealing with aggravated physical pain is already hard enough without adding emotional pain.

As I’ve already mentioned, in times like these, having a good self-management strategy is very important.  Your accredited exercise physiologist will be able to provide guidance with your exercise program.  This brings me to my last point of not stopping once you start.


Once you start an exercise program for your chronic pain, DON’T STOP!  A little disclaimer here I tell to nearly all my clients.  Exercising and improving your fitness, strength, flexibility or core strength may not eliminate your chronic pain.  But it might reduce it.  If your chronic pain is associated with degeneration, exercise may slow it down.  So if exercising is stopping you from progressing backwards, then you are actually making positive progress.

Having an effective exercise program designed by an accredited exercise physiologist can make a big difference.  It can be tailored to your specific condition and limitations.  Ideally, your program is something that you will be able to perform for a long time.  When you think about chronic disease and exercise.  Just think about your quality of life living with chronic pain.  If you were able to have less chronic pain and more function would that be a better place to be?