Physical activity and exercise of benefit for chronic pain

Physical activity and exercise of benefit for chronic pain

Brian McAvoy
PEARLS No.
551
Clinical question

How effective are different physical activity and exercise interventions in reducing pain severity and its impact on function, quality of life and healthcare use?

Bottom line

The broad spectrum of physical activity and exercise interventions assessed (aerobic, strength, flexibility, range of motion and core or balance training programmes, as well as yoga, Pilates and Tai Chi) were potentially beneficial, though the evidence for benefit was low-quality and inconsistent. There was evidence that physical activity reduced the severity of pain, improved physical function and had a variable effect on both psychological function and quality of life. However, these results were not found in all studies. The most commonly reported adverse events were increased soreness or muscle pain, which subsided after several weeks of the intervention.

Caveat

The inconsistency could be due to the quality of the studies or because of the mix of different types of physical activity tested in the studies. Of note, participants had predominantly mild-to-moderate pain, not moderate-to-severe pain.

Context

Chronic pain is defined as pain lasting beyond normal tissue healing time, generally taken to be 12 weeks. It contributes to disability, anxiety, depression, sleep disturbances, poor quality of life and healthcare costs. In the past, people with chronic pain were told to rest. However, general advice now is to keep active – whether to affect the pain directly or to combat the other problems associated with it.

Cochrane Systematic Review

Geneen LJ et al. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews.

Cochrane Reviews, 2017, Issue 1. Art. No.: CD011279.DOI: 10.1002/14651858. CD011279.pub2. This review contains 21 reviews with 381 studies involving 37,143 participants.