For people living with migraines, menstrual cramps or chronic pain, relief may not always come from medication alone. New research suggests that carefully structured exercise, including low-intensity activities such as Pilates and tai chi, can reduce pain by an amount comparable with the average benefit reported for common pain medicines.
The findings come from researchers at the University of Adelaide, who analysed 157 systematic reviews covering 2,736 randomised controlled trials and more than 220,000 participants. The study adds to growing health research examining exercise as part of a broader, non-drug approach to pain management.
What the study found about exercise and pain
Across a wide range of pain conditions, exercise reduced pain by about 1.1 points on a zero-to-10 scale. According to the researchers, that reduction was roughly 60% larger than the average relief reported in separate trials of medicines for chronic pain.
However, the results did not suggest that strenuous or lengthy workouts are necessary. In several comparisons, lower-intensity exercise produced greater pain relief than moderate-to-vigorous activity.
The most effective programmes tended to share several features:
- They used low-intensity or manageable forms of movement.
- They lasted about 12 weeks rather than continuing for much longer periods.
- They involved less than 120 minutes of exercise per week.
- They were adapted to the person’s condition, fitness and ability to participate consistently.
The results are particularly relevant for people whose pain makes conventional exercise difficult. A shorter, realistic programme may be easier to maintain than a demanding routine, while still providing meaningful benefits.
Why movement may reduce pain
The researchers identified several possible explanations for the effect. Physical activity can stimulate the release of chemicals such as endorphins and serotonin, which may influence pain perception and increase pain tolerance.
Exercise may also help regulate inflammation and alter how the brain processes pain signals. Improvements in mood, sleep and general physical function can provide additional support for people managing persistent symptoms.
These mechanisms do not mean that exercise removes the underlying cause of pain. Instead, movement may form one part of a wider treatment plan that could also include medical assessment, medication, physiotherapy or other therapies.
Exercise is not a universal replacement for medication
The study’s authors cautioned against presenting exercise as a cure-all. Pain has many causes, and the response to physical activity can differ according to the condition involved, a person’s current fitness, age and ability to follow the programme.
People with unexplained, severe or worsening pain should seek medical advice before changing their treatment. A sudden increase in activity may also aggravate some injuries or conditions, particularly if the exercise is not adapted appropriately.
The researchers said healthcare professionals need more precise guidance on prescribing exercise. Telling someone simply to “stay active” may not be enough. Patients may benefit from clear advice about:
- Which type of exercise is appropriate.
- How hard and how often to exercise.
- How long a programme should continue.
- How activity should be adjusted during a flare-up.
- When professional supervision is advisable.
What the findings mean for pain care
Exercise remains underused as a formal pain treatment, according to the study. Unlike medication, it is not routinely prescribed with the same level of detail, even though the evidence suggests that small and achievable amounts of activity may help.
The results support a more individualised approach to pain care. Instead of assuming that greater intensity delivers better results, clinicians could consider programmes that are practical, gradual and tailored to the patient.
This could include walking, gentle strengthening, stretching, Pilates, tai chi or other low-impact activities, depending on the person’s symptoms and medical advice. The appropriate choice will vary: an exercise that helps one patient may be unsuitable for another.
A cautious message for people living with pain
The central message is not that exercise should replace painkillers or professional care. Rather, structured movement may offer another evidence-based tool, particularly when it is introduced gradually and matched to an individual’s needs.
For someone living with chronic pain, a modest programme lasting less than two hours a week may feel more achievable than an intensive fitness plan. Consistency, safety and appropriate guidance appear more important than pushing for maximum effort.
Further research is still needed to establish which forms of exercise work best for particular pain conditions and how programmes should be prescribed. Until then, the findings point towards a balanced approach: use movement where it is safe and suitable, while continuing to seek medical advice for diagnosis and treatment.
Conclusion
This study suggests that exercise can provide meaningful pain relief, with low-intensity and shorter programmes sometimes outperforming more demanding routines. Exercise should not be treated as a universal substitute for medication, but it may become a more routine part of personalised pain care when healthcare professionals have clearer guidance on how to prescribe it.
