Exercise & Physical Therapy for Chronic Pain
When something hurts, the natural reaction is often to stop using it. Rest makes sense after some acute injuries. But with chronic pain, too little movement can sometimes make the problem worse.
Muscles become weaker, joints become stiffer, balance can decline, and activities that once seemed easy may become increasingly difficult.
Why Exercise Can Help
Regular movement can improve strength, flexibility, balance, and endurance. Exercise may also help with sleep and mood, both of which can influence how we experience pain.
The goal is usually not to exercise through severe pain. Instead, it is to find an amount of activity that is tolerable and gradually build from there.
Depending on the person and the cause of the pain, useful activities may include:
Walking
Strength training
Stretching and flexibility exercises
Swimming or water exercise
Tai chi or yoga
There is no single best exercise for everyone. An activity that someone enjoys and can continue doing is often more useful than a supposedly ideal program that is quickly abandoned.
What Can Physical Therapy Add?
A physical therapist can evaluate strength, flexibility, balance, posture, walking, and movement patterns and develop exercises for a person's particular problem.
Physical therapy can also help people who have become afraid to move because they expect activity to cause more damage.
For older adults, maintaining muscle strength and balance has benefits beyond pain relief. Staying physically capable can help preserve mobility and independence.
See Exercise, Muscle Strength & Healthy Aging for more about maintaining strength, improving balance, and preventing falls.
How Much Is Too Much?
One challenge is finding the right balance. Doing too much on a good day can sometimes lead to increased pain and several days of inactivity afterward.
A strategy known as pacing involves increasing activity gradually rather than repeatedly alternating between doing too much and then doing very little.
Some discomfort with increased activity does not necessarily mean that damage is occurring. But new, severe, or rapidly worsening pain should not simply be exercised through, particularly when accompanied by weakness, numbness, fever, unexplained weight loss, or other new symptoms.
For many people with chronic pain, the objective is not complete rest or vigorous exercise. It is regular, manageable movement that gradually improves what the body can do.
Learn More
ChoosePT — Physical Therapy Guide to Chronic Pain
A useful guide from the American Physical Therapy Association explaining how physical therapy, gradual exercise, strengthening, and education can help people with chronic pain.
CDC — Physical Activity for Older Adults
Practical guidance on aerobic exercise, strength training, and balance activities for adults 65 and older.