Why Exercising Regularly May Help You Deal With Pain Better
New research found that people who exercised regularly were better able to handle a pain test.
The researchers say this suggests exercise may help those with chronic pain.
Doctors say there are a few reasons why exercise may help build your pain tolerance.
While pain is part of life, it’s not exactly something people are eager to experience. Now, new research suggests doing something as simple as exercising regularly may help boost your pain tolerance.
The study, which was published in Plos ONE, used data from 10,732 adults in Norway and analyzed their self-reported activity levels, along with their pain tolerance. (Pain tolerance was measured by having people rank their pain on a scale when their hands were submerged in ice water.) The study participants were surveyed two times, with about an eight-year gap in between.
The researchers found that study participants who reported having higher levels of physical activity were more tolerant to pain. That was able to change with time—the researchers found that the capacity for pain tolerance increased the more people said they exercised during the study period.
“These results support increased physical activity levels as a possible non-pharmacological pathway towards reducing or preventing chronic pain,” the researchers wrote in the conclusion.
Pain management is complicated and there’s a lot experts don’t know about what, exactly, causes pain. So, can working out regularly help? Here’s the deal.
Why can regular exercise help with pain tolerance?
This isn’t the first study to link pain tolerance with exercise. An older study published in the British Journal of Sports Medicine found that people had a “significantly higher” pain threshold five minutes after doing a resistance exercise routine.
The latest study didn’t explore why people who exercise regularly seem to have a higher pain tolerance—it merely found a link. However, this is something that doctors say they see in patients as well. “Clinically, we notice that physical activity in chronic pain patients tends to improve their pain tolerance and decrease their pain,” says Medhat Mikhael, M.D., a pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif.
Dr. Mikhael says are a few theories on why this might be the case. One is that physical activity usually increases your heart rate, which ramps up levels of the feel-good hormone serotonin in your body. “Physical activity also can cause changes in the higher processing centers in the brain and modulate pain,” Dr. Mikhael says.
Regular movement can also help your body release endorphins, points out pain management expert Haijun Zhang, M.D., assistant professor in the Department of Anesthesiology at the Rutgers New Jersey Medical School. “Any muscle movement regularly will activate the brain to release endorphins, which are one of the most powerful internal peptides to treat pain,” he says. “They have a similar effect on the body to morphine—that’s why a lot of people feel good after exercise.”
Your immune system likely plays a role as well, according to Adrienne H. Simonds, P.T., Ph.D., assistant professor in the Doctor of Physical Therapy Program at Rutgers University. “Our immune system normally releases substances called cytokines. There are pro-inflammatory and anti-inflammatory factors,” she explains. “Exercise and physical activity promote the release of anti-inflammatory factors, such as IL-2, IL-4, IL-10, IL-13.” Since those factors encourage your body to reduce its inflammatory response, “people who exercise regularly may experience less bodily pain and improved pain tolerance,” Simonds says.
“There is both a protective pain mechanism that comes with exercise, and it also encourages you to keep it up,” says John Vasudevan, M.D., an associate professor of Clinical Physical Medicine and Rehabilitation at the University of Pennsylvania Perelman School of Medicine.
Exercise can help lower chronic pain over time, too, by strengthening your muscles and reducing the burden on your back and joints, Dr. Mikhael says.
What options do people currently have for chronic pain?
There are a lot of different treatment options available for chronic pain, and they can generally be divided into two camps: medical treatments and complementary therapies.
The right treatment varies by patient and their pain, but the Cleveland Clinic says the following medications are often used to treat chronic pain:
Anticonvulsants (medications that prevent seizures) for nerve pain
Antidepressants like as tricyclic antidepressants
Corticosteroids
Muscle relaxers
Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen
Topical products that contain pain relievers or ingredients that create soothing heat or cold
Opioids (for severe pain)
Sedatives to help with anxiety or insomnia
Medical marijuana
Other medical treatment options can include:
Transcutaneous electrical nerve stimulation (TENS): This is a procedure that delivers small electrical impulses through patches applied to your skin.
Nerve blocks: For a nerve block, your healthcare provider injects an anesthetic near the site of your pain to reduce feeling in the area.
Epidural steroid injections: This involves injecting an anti-inflammatory medicine (a steroid or corticosteroid) into the space around your spinal nerves known as the epidural space to treat chronic pain caused by irritation and inflammation of spinal nerve roots.
But research has shown that some complementary therapies can help with chronic pain management, too. According to the National Center for Complementary an Integrative Health (NCCIH), those can include:
Acupuncture
Hypnosis
Massage
Mindfulness meditation
Music-based interventions
Spinal manipulation
Tai chi
Quigong
Yoga
How to fit in exercise if you have pain
Dr. Zhang says that any exercise is better than none if you have pain. “Our instruction for patients typically is to exercise as long as you can tolerate it,” he says. “Do an exercise routine daily. It doesn’t matter for how long.”
As for what, exactly to do, he recommends checking in with your doctor or physical therapist. “All kinds of exercise can help,” Dr. Zhang says. “But if you have shoulder problems, we may focus on the shoulder; someone with knee problems will focus on strengthening the knee.”
Other factors, including considering when to exercise, are important, Simonds says. “Time of day is important to consider when scheduling exercise for individuals with chronic pain and other comorbidities because often, at the end of the day, physical activity may become more challenging because of fatigue or pain levels,” she says. “Therefore, scheduling physical activities earlier in the day when pain levels and fatigue are lower may improve participation in order to receive the health benefits.”
It also can be helpful to pair exercise with things people already enjoy. “Pairing exercise with daily activities and hobbies or interests can be a critically important strategy for individuals to get exercise throughout the day, rather than scheduling dedicated time with additional equipment and cost,” Simonds says. “This strategy can also reduce resistance to exercise and improve motivation because it makes exercise easier to access.”
Overall, it’s important to personalize your workout routine to you. “Exercise works like any other medicine. It works with the proper dose, frequency, and type,” Dr. Vasudevan says.
Dr. Zhang says that even five minutes of exercise can help. “As you go along, you can increase the time if you can tolerate it,” he says.
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