When you’re living with chronic pain, the idea of exercise can feel like punishment. Chronic pain patients are being constantly told that simply moving more will help them in the long run. True on paper, especially when you talk about building muscle to support joints. But for best results, research and patient experiences show that movement, done strategically, can reshape the way your body experiences pain.

“Movement is one of our top strategies to ease the sensitivity of the nerves,” says Uschold. Think of it like resetting that faulty alarm. “When we introduce blood flow and movement into the nervous system, the sensitivity of the nerves calms down. And when nerves are less sensitive, the alarm is less likely to go off.”

Exercise doesn’t just retrain the nervous system — it strengthens the whole body. “Through gradual stretching and strengthening, the brain learns that movement is safe again, which dials down the pain response,” says Helfrich. Over time, exercise also releases endorphins, improves mood, and boosts energy, helping break the depression-pain cycle. The science backs it up. Dozens of studies show that regular activity reduces pain severity and improves function. A 2022 meta-analysis found that patients with fibromyalgia who followed aerobic, strength, or flexibility programs reported less pain, fewer depressive symptoms, and improved quality of life months later. And a 2017 systematic review even found that people who tolerated mild discomfort during exercise did just as well long-term as those who stayed pain-free, suggesting a little soreness isn’t harmful and may even signal progress.

Movement can also restore a sense of agency. A 2023 review of chronic low back pain found that consistent movement improves self-efficacy (the belief that you can manage your pain), which is one of the strongest predictors of long-term recovery.

But it hurts. That’s why sticking with it is hard. In a 2024 study, every participant reported pain during exercise. For some, the sharp spikes of a flare-up felt like proof they were doing something wrong. For others, the frustration was quieter but no less corrosive: pushing through week after week without seeing any change in pain. If exercise seemed to make their pain worse — or at least didn’t lessen it — what was the point of keeping at it? That sense of futility became one of the most powerful barriers to adherence, often undercutting the fragile confidence participants were working to build. “There’s no one-size-fits-all solution,” notes researcher Yannick Gilanyi, a PhD candidate at the Neuroscience Research Australia Centre for Pain IMPACT in Sydney, Australia. “Exercise has the potential to increase pain self-efficacy — or reduce it — depending on how it’s delivered.”