In the asymptomatic population, just a single bout of aerobic, isometric, or dynamic resistance exercises have been shown to produce short-lasting hypoalgesia (mind you, 5 – 30 minutes only). The pain desensitization benefits of physical activity (PA) may be partially attributed to increased release of endogenous opioids and serotonin (Rice et al 2019).

However, are there any pain desensitizing benefits to PA for those experiencing chronic pain? The answer is perhaps sometimes, maybe, it depends!

Regrettably, the positive responses to PA seen in asymptomatic individuals is not consistently experienced by those with chronic pain… some experienced no change, some feel worse, yet some feel better. So can we predict who is less likely to benefit from PA? The answer is actually yes, and here are the top 3 predictors (Vaegter et al 2020).


  1. The presence of widespread pain
  2. The use of pain medications
  3. Negative beliefs about exercise leading to pain or tissue damage


“Despite the varying and sometimes inconsistent relationship between exercise and pain, physical activity and exercise remain the best available low-cost, minimal-risk, and convenient intervention for managing symptoms and improving functions in non-inflammatory chronic musculoskeletal pain.” – Chang et al 2023 IASP Fact Sheet


Other than the potential pain-relieving benefits, physical activity may also have the following benefits

  • Strengthens muscles
  • Enhances mood and mental health
  • Improves sleep
  • Reduces chronic inflammation
  • Promotes positive beliefs about the relationship between movement and pain

As PTs we are responsible for personalizing our patients’ physical activities and exercises based on their goals, motivation, and their unique medical and mental health condition.  This is an incredible responsibility as if it’s not done correctly, it can lead to negative beliefs towards physical activity, further reinforcing chronic pain behaviors of activity avoidance.

 Sincerely, Bahram Jam, PT

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