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New research has found that people who exercised regularly were better able to handle a pain test.
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The researchers say this suggests that exercise may help chronic pain sufferers.
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Doctors say there are a few reasons exercise can help build your pain tolerance.
While pain is a part of life, it’s not exactly something people are eager to experience. Now, new research suggests that doing something as simple as exercising regularly can help increase your pain tolerance.
The study, 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 asking people to rate their pain on a scale when their hands were dipped in ice water.) Study participants were interviewed twice, with an interval of about eight years in between .
The researchers found that study participants who reported having higher levels of physical activity were more tolerant of pain. That was able to change over time: The researchers found that pain tolerance increased the more people said they exercised during the study period.
These findings support increasing physical activity levels as a possible nonpharmacological pathway toward the reduction or prevention of chronic pain, the researchers wrote in the conclusion.
Pain management is complicated, and there are many experts who don’t know what, exactly, is causing pain. So, can exercising 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 British Journal of Sports Medicine found that people had a significantly higher pain threshold five minutes after performing a resistance exercise routine.
The latest study didn’t explore why people who exercise regularly appear to have higher pain tolerance, it simply found a link. However, this is something doctors say they see in patients as well. Clinically, we see that physical activity in chronic pain patients tends to improve their pain tolerance and decrease their pain, says Medhat Mikhael, MD, pain management specialist and medical director of the nonoperative program at the Health Center of the spine at MemorialCare Orange Coast Medical Center in Fountain Valley, California.
Dr. Mikhael says there are some theories as to why this might be the case. One is that physical activity usually increases your heart rate, which increases levels of the feel-good hormone serotonin in your body. Physical activity can also cause changes in higher processing centers in the brain and modulate pain, says Dr. Michael.
Regular movement can also help your body release endorphins, points out pain management expert Haijun Zhang, MD, assistant professor in the Department of Anesthesiology at Rutgers New Jersey Medical School. Any muscle movement on a regular basis will trigger the brain to release endorphins, which are one of the most powerful internal peptides for treating pain, he says. They have a similar effect on the body to morphine, which is why many people feel great after exercise.
Your immune system likely plays a role, too, according to Adrienne H. Simonds, PT, 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. Because these factors encourage your body to reduce its inflammatory response, people who exercise regularly may experience less physical pain and improve pain tolerance, Simonds says.
There’s both a pain protective mechanism that comes with exercise and also encourages you to keep going, says John Vasudevan, MD, associate professor of Clinical Physical Medicine and Rehabilitation at the University of Pennsylvania Perelman School of Medicine.
Exercise can also help reduce chronic pain over time by strengthening muscles and reducing the strain on your back and joints, says Dr. Michael.
What options do people currently have for chronic pain?
There are many 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 depending on the patient and their pain, but the Cleveland Clinic says the following medications are often used to treat chronic pain:
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Anticonvulsants (medicines that prevent seizures) for nerve pain
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Antidepressants such as tricyclic antidepressants
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Corticosteroids
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Muscle relaxants
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Nonsteroidal anti-inflammatory drugs (NSAIDs) or paracetamol
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Topical products that contain pain relievers or ingredients that create soothing heat or cold
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Opiates (for severe pain)
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Sedatives to help with anxiety or insomnia
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Medical marijuana
Other medical treatment options may include:
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Transcutaneous Electrical Nerve Stimulation (TENS): This is a procedure that delivers small electrical impulses through patches applied to the skin.
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Nerve blocks: For a nerve block, your doctor injects an anesthetic near the site of your pain to reduce sensation in the area.
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Epidural steroid injections: This involves injecting an anti-inflammatory medicine (a steroid or corticosteroid) into the space around the spinal nerves known as the epidural space to treat chronic pain caused by irritation and inflammation of the spinal nerve roots.
But research has shown that some complementary therapies can help with chronic pain management as well. According to the National Center for Complementary an Integrative Health (NCCIH), these can include:
How to adapt to exercise if you have pain
Dr. Zhang says any exercise is better than none if you’re in pain. Our instruction for patients typically is to exercise as long as you can tolerate it, he says. Perform an exercise routine every day. It doesn’t matter how long.
As for what, exactly to do, he recommends that you consult your doctor or physical therapist. All types of exercise can help, Dr. Zhang says. But if you have shoulder problems, we could focus on your shoulder; someone with knee problems will focus on strengthening the knee.
Other factors, including considering when to exercise, are important, Simonds says. The time of day is important to consider when planning exercise for people with chronic pain and other comorbidities because often, at the end of the day, physical activity can become more challenging due to fatigue or pain levels, he says. Therefore, scheduling physical activities earlier in the day when pain and fatigue levels are lower may improve participation in order to receive health benefits.
It can also 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 people to get exercise throughout the day, rather than scheduling dedicated time with extra equipment and costs, says Simonds. This strategy can also reduce exercise resistance and improve motivation because it makes access to exercise easier.
Overall, it’s important to tailor your exercise routine to you. Exercise works like any other medicine. It works with the correct dose, frequency and type, says Dr. Vasudevan.
Dr. Zhang says even five minutes of exercise can help. As you go, you can increase the time if you can tolerate it, he says.
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