Chronic pain is a barrier to exercise for many older Australians. Yet research suggests that the right kind of exercise is one of the most useful approaches for many types of chronic pain. This article explores evidence-based approaches to exercise when pain has previously stopped you from moving.
The Pain-Movement Paradox
Pain naturally makes you want to avoid movement. Resting feels protective. Yet prolonged inactivity tends to make most chronic pain worse by:
- Weakening muscles that support joints
- Reducing bone density and increasing fragility
- Increasing stiffness and reducing flexibility
- Worsening mental health and depression
- Reducing cardiovascular fitness
Research consistently suggests that gentle, progressive movement is associated with reduced pain and improved function over time.
Common Chronic Pain Patterns in Older Adults
Wear-and-Tear Joint Pain
Particularly affecting knees, hips, and hands. Often associated with:
- Weaker muscles around the joint
- Poor alignment and movement patterns
- Stiffness from inactivity
Exercise may help by strengthening supporting muscles and improving alignment.
Lower Back Pain
Often associated with weak core muscles, poor posture, or past injuries. Tends to improve with:
- Core strengthening exercises
- Good posture and body mechanics
- Flexibility work, particularly hamstrings and hip flexors
Nerve-Related Pain
Sometimes associated with diabetes. Often supported by:
- Regular, consistent movement
- Careful attention to foot health and sensation
- Exercises that improve balance (which may reduce falls risk)
Widespread Pain Conditions
Conditions involving widespread pain tend to improve with:
- Gentle, consistent aerobic activity
- Strength work (despite initial discomfort)
- Mind-body techniques like yoga or tai chi
Principles of Safe Exercise With Chronic Pain
Start Low and Go Slow
Begin with short, easy sessions and progress gradually. A 10-minute walk three times weekly is far better than pushing too hard once weekly.
Choose Low-Impact Activities
Walking, swimming, water aerobics, cycling, and tai chi avoid the high-impact movements that often aggravate pain.
Distinguish Between Pain and Harm
Some discomfort during movement is normal and not harmful. Sharp pain, sudden onset, or pain lasting hours after exercise suggests you have overdone it. The general rule: 'good pain' eases somewhat within 2 hours of exercise; 'bad pain' worsens or persists.
Consistency Over Intensity
Regular gentle movement tends to be more valuable than occasional intense effort. Aim for most days weekly.
Use Heat or Cold as Needed
Warm muscles before exercise; ice afterwards if inflammation occurs.
Specific Strategies for Different Pain Situations
Exercise That Worsens Pain
If an activity consistently worsens pain:
- Stop that activity and try alternatives
- Modify the movement (shorter range, slower speed, lower intensity)
- Use props like chairs, walking poles, or water resistance
- Ask a physiotherapist for movement correction
Flare-Ups and Setbacks
On days when pain is worse:
- Gentle movement (walking, stretching) often helps more than complete rest
- Reduce intensity rather than avoiding activity entirely
- Expect temporary setbacks; they are not permanent failure
Medication Timing
If you take pain medication:
- Time exercise for when medication is most effective
- Discuss timing with your GP or pharmacist
- Do not rely on masking pain without addressing underlying issues
Professional Support
Your GP can help significantly:
- Clarify which movements are safe with your specific condition
- Refer to physiotherapy for assessment and movement correction
- Consider pain management programmes
- Discuss medications that might help
Many councils offer subsidised or free physiotherapy to older adults through their health programmes.
Evidence-Based Approaches for Common Pain Patterns
Wear-and-Tear Joint Pain
- Strength training, done twice weekly, is associated with meaningful reductions in pain over time
- Weight-bearing exercise supports joint health
- Stretching and flexibility work tends to be helpful
Lower Back Pain
- Core strengthening tends to be more useful than passive treatments
- Walking and pilates-style exercises are often particularly beneficial
- Posture correction is associated with reduced symptom flare-ups
Widespread Pain
- Regular aerobic activity is associated with reduced symptoms
- Start very gently; effects often improve over months
- Consistency matters more than intensity
Psychological Dimensions
Pain has significant psychological components:
- Catastrophic thinking about pain often worsens it
- Confidence in movement improves outcomes
- Group exercise (classes, groups) provides psychological benefit beyond the physical
- Achieving movement goals despite pain builds self-efficacy
Building a Pain-Conscious Exercise Plan
- Choose activities you enjoyed before pain limited you
- Start at 50 percent of what you think you can do
- Increase duration before increasing intensity
- Include variety to help reduce the risk of overuse injuries
- Monitor patterns: which activities help, which worsen pain
- Celebrate small gains in function
A Practical Step You Can Take Today
Pick the gentlest activity from the list above (often a five-minute walk or a few seated stretches) and do it once today. Note your pain level out of ten before and 90 minutes after. Repeating this short check for one week often gives you genuinely useful information about which activities help and which do not.
Important Note
This information is general in nature and is not a substitute for professional medical advice. Please consult your GP before making changes to your health routine.