Dan Mager

The wide-ranging benefits of exercise are becoming increasingly well-known. To an extensive list that encompasses weight management, improved heart health, lower risk of cancer, stronger muscles and bones, and increased ability to perform daily functions can now be added another of considerable value: greater ability to handle pain—including chronic pain. A study recently published in the journal PLOS One using data from more than 10,000 adults found that exercise is an effective way to reduce chronic pain.[1]

Chronic pain prevalence

Chronic pain is on the rise in the U.S., with new cases of chronic pain occurring more often among U.S. adults than new cases of diabetes, depression, and high blood pressure. According to an analysis of National Health Interview Survey (NHIS) data, the current rate of chronic pain and high-impact chronic pain (HICP) among adults in the U.S. is approximately 21 percent and 8 percent, respectively. Chronic pain is pain that is experienced on most days or every day in the past three months, and HICP is pain that limits life or work activities on most days or every day during the past three months. Chronic pain is extremely persistent, with 61.4 percent of those who reported chronic pain in 2019 still reporting it a year later.[2]

The new PLOS One study indicates that even though exercise may be the last thing a person challenged with chronic pain wants to do, it could be a critical element in recovery. Researchers at the University Hospital of North Norway in Tromsø analyzed people’s self-reported activity levels and their pain tolerance. Pain tolerance was measured using what’s known as the cold pressor test, in which people’s hands are immersed in ice water between 32 and 41 degrees Fahrenheit to see how long they can endure it. Participants were surveyed twice using this method, seven to eight years apart.

Those with more active lifestyles were found to be more tolerant to and better able to handle pain—and the more people said they exercised over the course of the study, the more their capacity for enduring pain increased. Participants who had increased their levels of physical activity during the interim period between the two surveys reported greater pain tolerance over time. In evaluating the results, the researchers found that for both rounds of participation, in terms of pain tolerance, any activity level was better than being sedentary. There was no difference in these results between men and women.

Importantly, there was a direct correlation between more exercise and a better ability to handle pain in that the higher a person’s total activity levels, the greater their pain tolerance. Moreover, chronic pain did not diminish the positive effects of physical activity on pain tolerance, as the results were as robust for those with chronic pain as for those without it. This research makes clear that more frequent physical activity has the important potential to be part of a non-pharmacological pathway toward reducing chronic pain, increasing functioning, and improving quality of life.

This isn’t the first study to positively link pain tolerance with exercise. A 1998 study published in the British Journal of Sports Medicine found that people had a significantly higher pain threshold five minutes after doing a resistance exercise routine.[3] And in 2020, an Australian study published in the journal BMC Musculoskeletal Disorders evaluated nearly 600 participants who suffered from chronic musculoskeletal pain. Those who did regular aerobic physical activity, including walking or cycling, experienced higher pain thresholds.[4]

This latest research didn’t examine the specific mechanisms behind why people who engage in physical activity have a higher pain tolerance—but the linkage it shows between the two is clear. The Norwegian study is a powerful reminder that lifestyle choices, changes, and interventions will always have a critical role in addressing certain chronic illnesses.