Exercise may be a more powerful tool for pain relief than many people realize, according to a large analysis spanning hundreds of thousands of participants.
Pain often makes movement feel like the wrong choice. Yet a large new analysis suggests that exercise can reduce pain across conditions ranging from osteoarthritis and migraine to neurological disorders, inflammatory diseases, and cancer-related pain.
Researchers at Adelaide University analyzed 157 systematic reviews covering 2,736 randomized controlled trials and 221,279 participants. Across that evidence, exercise was associated with reductions in both acute and chronic pain, making the study the most comprehensive synthesis to date of exercise as a pain treatment.
Less Exercise May Still Bring Meaningful Relief
The results challenge the assumption that harder or longer workouts are necessary for pain relief. Lower intensity and shorter duration programs produced greater reductions in pain, while meaningful benefits were also seen in programs totaling less than two hours of exercise per week.
On average, exercise reduced pain by about 1.1 points on a 0 to 10 scale. The researchers noted that this reduction was roughly 60% larger than the average pain relief reported for commonly used medications in separate trials involving chronic pain. Because those drug studies were separate rather than direct head-to-head comparisons, the finding does not show that exercise outperforms medication for any individual condition.
Globally, chronic pain affects about one in five adults. Despite its prevalence, exercise is still often recommended in broad terms rather than prescribed with the same level of detail used for medications.
How Movement Can Change Pain
Lead researcher Dr. Ben Singh said exercise may influence pain through several biological pathways.
“When we exercise, our body releases chemicals including endorphins and serotonin that can help reduce how strongly we feel pain and increase our pain tolerance,” Dr Singh said.
“Additionally, it helps calm inflammation and change the way our brain responds to pain, while also improving mood.
“These effects help explain why exercise can be such a powerful tool for pain management. Yet despite the evidence, it isn’t used as routinely as it could be and is rarely prescribed with the same precision as medication.
“Instead, people experiencing pain may be told to ‘stay active’, rather than being given a specific, evidence-based exercise program that considers what type of exercise to do, how hard to work and for how long.”
Benefits Appeared Across Different Types of Exercise
The researchers examined whether pain relief varied according to exercise type, intensity, and duration, and whether the effects differed between acute and chronic pain. Benefits appeared across aerobic exercise, resistance training, yoga, Pilates, and tai chi.
“Our study found that exercise was associated with substantial reductions in acute and chronic pain across all forms of exercise – whether that be via aerobic or resistance exercise, or through gentler movement such as yoga, Pilates or tai chi.
“Importantly, we found that more exercise wasn’t necessarily better. In fact, shorter-duration and lower-intensity programs showed greater reductions in pain, suggesting people may not need to exercise harder or for longer to experience meaningful benefits.”
Toward More Precise Exercise Prescriptions
Senior researcher Professor Carol Maher said the findings support a larger role for exercise within multimodal pain care, in which physical activity can be combined with other treatments according to a patient’s condition and needs.
“Health care providers need definitive guidance, not just whether exercise helps, but which exercises work for which patients, and how to prescribe them effectively,” Dr Singh said.
“These findings should provide clinicians with considerable flexibility and increased confidence to prescribe exercise as a core, scalable component of pain management across diverse conditions.
“At a time when we’re looking for safe and effective ways to manage pain beyond medication, these findings provide strong evidence for making exercise a more routine part of pain care.”
Reference: “The effect of exercise on clinical pain: a systematic umbrella review and meta-meta-analysis” by Ben Singh, Aaron Miatke, Dot Dumuid, Rachel Curtis, Kimberley Szeto, Kylie Dankiw, Emily Eglitis, Jasmine Petersen, Mason Zhou, Catherine Simpson, Lisa Matricciani, Felicity Braithwaite, Tasha Stanton and Carol Maher, August 2026, PAIN Reports.
DOI: 10.1097/PR9.0000000000001455
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