Exercise with Persistent Pain: What To Do
Graded physical activity as a core treatment for chronic pain.
Last revised
It is recommended for chronic primary pain, and the common fear that movement causes damage is what keeps people still.
Key takeaways
- Recommended: supervised exercise programmes for chronic primary pain
- Type: the evidence does not favour one form over another
- Most useful single change: Choose an activity you will actually keep doing.
- Commonest mistake: Waiting to be pain-free before starting.
- See a doctor if any of the signs under "When to get help" below apply to you.
Do
- Choose an activity you will actually keep doing
- Start below what feels possible and build slowly
- Expect a temporary increase in symptoms and continue
- Ask for supervised or group programmes where available
Do not
- Waiting to be pain-free before starting
- Boom-and-bust patterns on good days
- Stopping at the first flare
The figures behind the list
Each item above follows from these, published in the guidance named at the foot of the page.
| Measure | Figure |
|---|---|
| Recommended | supervised exercise programmes for chronic primary pain |
| Type | the evidence does not favour one form over another |
| Expected | some increase in symptoms initially; it does not indicate damage |
| Progression | gradual, from a sustainable baseline |
Where to go next
- Exercise with Persistent Pain for Beginners: Where to Start
- Exercise with Persistent Pain: Common Questions Answered
- Exercise with Persistent Pain — the reference entry
- Flare Management: What the Evidence Actually Says
- The Evidence on Talking to Clinicians About Pain, Without the Hype
When to get help
Stop and seek assessment for new weakness, numbness, a joint that gives way, or pain that is sharp and different from your usual pattern. Seek emergency care for numbness around the genitals or back passage, bladder or bowel changes, or weakness in both legs.
Where this comes from
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.