Pain is your body’s way of telling you that something needs attention. Usually, it settles as an injury heals, but for many people pain doesn’t always disappear after recovery. Instead, it can linger for months or years, affecting work, hobbies, sleep, mental wellbeing, and everyday life.
Living with chronic pain can be incredibly frustrating, and nearly 1 in 5 Australians experience it. You may feel like you’ve tried everything or worry that moving will make things worse. The good news is that while chronic pain is complex, there are effective strategies that can help you regain confidence, improve your function, and reduce your pain over time.
In this article, NeuroMoves Physiotherapist Noah offers some top tips for how to safely and comfortably exercise with chronic pain, what to do during a flare up, and how to manage chronic pain.
Table of Contents
What is chronic pain?
Chronic pain is pain that persists longer than would normally be expected for an injury to heal. Recovery times vary depending on the type of injury, your overall health, and the demands of your daily life or exercise routine. Generally, pain that continues beyond 4–6 months is considered chronic.
Chronic pain can present in many ways. Some people experience constant discomfort, while others notice their symptoms fluctuate from day to day. You may have periods where you feel almost normal, followed by flare-ups that seem to come out of nowhere. This unpredictability is one of the reasons chronic pain can be so challenging to manage.
Who can experience chronic pain?
While anyone can develop chronic pain, there are certain factors that can increase the risk of an injury or condition becoming long-term. These include:
- Jobs or lifestyles where it’s difficult to avoid aggravating movements or positions
- Spending prolonged periods in one position, such as using a wheelchair
- Previous psychological trauma or high levels of stress
- Trauma associated with the original injury, such as whiplash sustained during a motor vehicle accident
It’s important to remember that these are risk factors, not guarantees. Chronic pain is influenced by many physical, psychological, and social factors, which is why every person’s experience is unique.
Should I exercise with chronic pain?
One of the biggest misconceptions about chronic pain is that movement should be avoided.
While exercise can sometimes increase pain in the short term, research consistently shows that appropriate, gradual movement is one of the most effective ways to reduce pain and improve function over the long term.
The key isn’t pushing through intense pain or exercising as hard as possible, it’s about finding the right amount of movement for your current capacity and gradually building from there.
Top tips for managing exercise with chronic pain:
1. Learn what triggers your pain
Understanding your individual pain triggers is the first step towards managing them. Keeping a simple diary of activities, stress levels, sleep, and symptoms can help identify patterns.
2. Find your baseline
Work out how much movement or activity you can comfortably tolerate without causing a significant flare-up. This baseline might be much smaller than you’d like and that’s okay. Starting where your body is currently at gives you the best chance of making steady progress.
3. Build up slowly
Once you’ve established your baseline, increase your activity gradually over time. Small, consistent improvements are far more effective than trying to do too much too quickly.
4. Avoid the boom-and-bust cycle
Many people with chronic pain have “good days” where they feel capable of catching up on everything they’ve missed. Unfortunately, overdoing it often leads to several painful days afterwards. Instead, try to pace yourself. Doing a manageable amount consistently is usually far more beneficial than alternating between doing too much and doing very little.
5. Celebrate every win
Progress doesn’t always come quickly. Meaningful improvements are worth recognising. Celebrating these successes helps create positive associations with movement and reinforces confidence in what your body can do.
6. Remember: pain does not always equal damage
One of the most important concepts in chronic pain management is understanding that pain and tissue damage are not always the same thing. Over time, the nervous system can become sensitised to movement, meaning movements that are safe may still feel painful.
However, please always discuss any new, severe or unexplained pain with your GP or healthcare professional. Any new symptoms such as sudden weakness or numbness should be discussed, to ensure these are properly assessed.
A physiotherapist can help identify which movements are safe and develop a plan that gradually rebuilds your confidence.
7. Don’t rely solely on passive treatments
Treatments such as massage, heat packs, and pain medication can all play an important role in managing symptoms. However, these approaches generally provide temporary relief rather than targeting any underlying factors that might be contributing to pain. Long-term improvements usually come from increasing your body’s capacity through movement, strength, education, and gradually returning to meaningful activities.
Finding the right type of exercise for chronic pain
When you’re living with chronic pain, gentle movement is often the best place to start. Many people find it easier to exercise in environments where they feel safe, comfortable, and supported, whether that’s at home, outdoors with family or friends, or in a class.
Activities such as yoga, Pilates, and Tai Chi are excellent options because they can be modified to suit almost any fitness or pain level.
The best exercise is ultimately one that you enjoy, can do consistently, and is appropriate for your individual condition. Working with a physiotherapist or exercise physiologist can help ensure your program matches your current abilities and goals.
What should I do during a flare-up?
With chronic pain, flare-ups are unfortunately part of the journey. Rather than asking if they’ll happen, it’s often more helpful to prepare for when they happen.
The goal isn’t to avoid every flare-up completely but to reduce how often they occur and minimise their severity.
If your pain flares:
- Reduce the intensity or amount of activity but avoid stopping movement altogether
- Continue with gentle movement within your comfort level
- Use symptom relieving strategies such as heat, massage, or other treatments that you know help
- Return gradually to your normal activity levels as your symptoms settle
- If you’re unsure how to manage a flare, book in with your physiotherapist for individual advice
Maintaining some movement during a flare-up helps keep your nervous system active without becoming overly protective, which can often help symptoms settle more quickly.
When should I seek help?
If pain is beginning to affect your daily activities, work, exercise, sleep, or mental wellbeing, it’s worth seeking advice to develop a plan and management tools that get you back to your daily routine.
Early intervention can often prevent chronic pain from becoming more persistent and debilitating.
Even if your condition turns out to be relatively straightforward, a physiotherapist can provide reassurance, explain what’s happening, and give you practical strategies to support your recovery.
If you’re already seeing a physiotherapist or exercise physiologist for another reason, don’t hesitate to mention any ongoing pain concerns. We’re always happy to help and, if needed, can guide you towards the most appropriate treatment or specialist care.
Living with chronic pain can feel overwhelming, but it doesn’t have to define your life. With the right education, a personalised exercise plan and support from experienced health professionals, like NeuroMoves, it’s possible to improve your function, reduce pain, and get back to doing the things you enjoy.
If you, or someone you know, lives with chronic pain and are interested to learn more about how we can help, please visit the links below:
