October 13, 2022 10 min read

In pain management, exercise and movement are pivotal components that hold the key to pain relief.  A consensus among pain researchers and healthcare experts highlights the transformative potential of heightened physical activity in enhancing pain management, functional capabilities, and overall well-being across various persistent pain conditions. These conditions include osteoarthritis, back and neck pain, shoulder discomfort, fibromyalgia, and post-operative pain.

While exercise is a recommended strategy for individuals dealing with persistent pain, the duration of pain experienced can serve as a deterrent to initiating such regimens. Consequently, physical activities and even day-to-day motions can become sources of increased pain, and pain exacerbation can become more frequent, intense, and prolonged for those grappling with prolonged pain. This cascade effect can erode confidence, foster anxiety or apprehension surrounding physical activity, and ultimately steer individuals away from exercise, exacerbating their pain levels.

Fortunately, the silver lining emerges when individuals tailor their exercise routines to their unique circumstances, positively impacting the pain processing system. As exercise tolerance rises, the phenomenon of pain sensitization diminishes. This translates to fewer and less severe pain flare-ups as the individual's system grows less responsive.

The best way to begin and increase an exercise regime with pain is in the water.  Exercising in a heated pool is often referred to as a natural painkiller.


Living with persistent pain can be incredibly debilitating, a fact that anyone in this situation knows all too well. Chronic pain is characterised by its duration, lasting for more than three months or often extending beyond the typical healing period. Whether you're personally grappling with chronic pain or acquainted with someone who is, it's essential pain is understood and to be aware of the following key elements:

Authenticity of Pain

Pain constitutes an authentic and often distressing personal encounter. Much like other sensory perceptions such as fear, hunger, thirst, and fatigue, pain is a genuine experience. While individuals genuinely undergoing pain feel its impact, it's important to note that the pain level doesn't necessarily mirror the extent of tissue damage.

Multifaceted Nature of Pain

Numerous factors contribute to the intensity of pain a person feels. Any information perceived by your brain as a threat can influence pain perception. Variables, including tissue damage, personal beliefs about pain, movement-related anxiety, inadequate coping mechanisms, physical inactivity, and emotional factors, collectively influence the degree of pain one experiences.

Alarm System of Pain

Pain serves as the body and brain's alarm system. It's designed to safeguard us from harm, such as experiencing pain when lifting a heavy load. Over time, the system can become excessively cautious, causing increased pain even when dealing with less strenuous activities.

Pain and Tissue Damage

Pain doesn't always correlate directly with tissue damage. Instead, it acts as a safeguard mechanism when tissue damage occurs, or the brain senses a potential threat to tissues. Pain can motivate protective behaviours, like limping, to prevent further harm. However, the brain may choose not to produce pain when other priorities outweigh safeguarding a specific body part.

The first step toward progress involves comprehending pain. It's crucial to recognize that pain doesn't directly indicate damage. Engaging in movement is safe, and one need not be entirely pain-free to reinitiate activity. This understanding aids in overcoming the fear of pain and motion, facilitating a return to enjoyable life activities.

Pain is both helpful and unhelpful

Acute pain, lasting less than three months, is beneficial as it encourages protection of an injured area, aiding tissue healing. In contrast, persistent pain, lasting beyond three months or anticipated healing time, becomes counterproductive, persisting even when the need for protective measures diminishes.

Brain's Role in Pain

Pain is a product of brain function, not an external input. The brain determines the level of pain or protection required, with non-physical factors (like beliefs and movement fears) gaining importance as pain endures.

Invisibility of Pain

Pain doesn't manifest on medical scans. Both pain sufferers and those without pain can exhibit signs of tissue damage on scans. These changes are often attributed to normal ageing processes and don't comprehensively explain the experience of pain.

Physical Activity as Relief

The next step involves re-establishing physical activity. Exercise significantly increases strength, confidence, and endurance while reducing apprehension about movement and pain.

Focus on Function

Setting goals is vital for those enduring persistent pain. These objectives should centre on enhancing functionality and re-engaging in activities that pain has hindered. Rather than aiming solely for a pain-free state, embarking on a journey of gradual recovery is more effective.


Persistent pain is a multifaceted experience that involves the brain's complex interactions and extends beyond mere tissue damage. Understanding pain's intricacies, engaging in movement, and focusing on functional recovery can collectively contribute to improved quality of life despite ongoing pain challenges.

Though commonly perceived benefits of exercise for persistent pain encompass enhanced muscle strength, endurance, mobility, joint lubrication, and flexibility, the scope of advantages extends far beyond these dimensions. Regular exercise and physical activity enact many positive changes across the body's various systems, including the cardiovascular, nervous, brain, hormonal, and immune systems. Exercise emerges as a countermeasure to the negative ramifications often associated with persistent pain, encompassing a weakened immune system, diminished fitness, strength, resilience, and adverse effects on mood. The collective impact of these systemic changes can significantly benefit individuals grappling with persistent pain.


The realm of exercise-related health benefits for individuals enduring persistent pain is expansive, encompassing:

  1. Enhanced Sleep: Individuals navigating persistent pain often find themselves trapped in a cycle where inadequate sleep heightens their pain levels. Exercise plays a role in resetting the nervous system, promoting relaxation, and dampening the "fight or flight" response, improving sleep quality.

  2. Elevated Mood and Stress Reduction: Exercise can lower pain perception by enhancing the production and receptivity of natural "feel-good" hormones and neurotransmitters like dopamine. This mechanism bears similarities to the action of certain commonly prescribed pain medications, potentially reducing reliance on such medicines.

  3. Increased Pain Tolerance and Desensitization: Even a brief exercise session, such as a brisk 20-minutes, can reduce pain post-exercise by 20-30 min. Consistent daily exercise can raise pain tolerance and facilitate the resumption of activities that were halted or restricted due to pain.

  4. Improved Immune Function & Reduced Inflammation: Exercise's ability to enhance circulation and modulate the immune system's activity reduces systemic inflammation. As heightened inflammation often fuels pain and low mood, this effect becomes particularly valuable for various chronic conditions.


If you have ever experienced chronic pain or know someone who has, you know that it can be relentless. It can also be determined in its quest to take your life. Chronic pain can cause you to lock yourself indoors, keep to yourself, and exhaust yourself with activities that will never end.

Water enables ease of movement with out impact on the body causing more pain and is a proven treatment for pain and it's associated symptoms.  Submerging the body up to the chest level results in an 80% reduction in body weight. This reduction proves highly beneficial for those undergoing muscle and joint retraining, creating a gentle environment conducive to faster healing.

The water's warmth provides direct relief to the skin, alleviating pain, while its pressure supplies the necessary resistance to enhance the difficulty of treatment-specific exercises. 

The warm water provides relief from discomfort, enabling you to engage in gentle exercises with greater ease. The water-based exercises trigger the release of endorphins, chemicals that foster a sense of well-being and happiness while acting as the body's natural painkillers. Similar to opioids, endorphins interact with the body's opioid receptors in the nervous system, inducing an analgesic effect, but without the accompanying side effects.

Immersing oneself in the heated water is believed to interrupt pain signals, contributing to pain relief. A research study explains this phenomenon as follows: 'The hydrostatic pressure, viscosity, and water temperature stimulate thermal and mechanoreceptors while blocking pain receptors, thereby creating sensory-motor hyperstimulation.' This resembles the way using a heat pad on sore areas can ease muscle tension and pain, or how rubbing a painful spot generates a different sensation that disrupts pain signals.

Frequently, individuals who have become inactive due to fear avoidance (apprehension about exacerbating symptoms) can lose confidence and convince themselves that certain movements are beyond their capability. Exercising in water alleviates joint stress, making movement much more manageable. Learning how to perform movements in the water gradually rebuilds confidence, demonstrating that they can participate in physical activities and that their body is indeed capable of movement. Consequently, this enhances the likelihood of them integrating exercise into their daily routines.

Conducting movements in an environment that diminishes pain also assists in retraining the brain away from associating those movements with pain. The brain learns that these actions are not to be feared and need not cause pain. As a result, the brain reduces its signaling in response to these movements. If patients continue to exercise post hydrotherapy, this positive cycle persists, reinforcing the benefits.

The Benefits of water exercise for pain and its consequences:

Water exercise can help with pain related sleep problems

Water exercise can help with sleep problems by relaxing the body and soothing the mind. When you're tense or anxious from chronic pain, your body's muscles tighten, leading to headaches, migraines, and even insomnia. Water exercise can help relieve that tension and allow your body to relax. The heat from the water can also help improve circulation and ease any pain or stiffness in the muscles. Water exercise offers a way to regain control over your chronic pain. It can be a refreshing way to destress and reset your body, mind, and spirit. Recreational and controlled water activities are excellent for helping to manage stress levels, relieve tension, and relieve muscle aches. However, these activities can be even more beneficial regarding chronic pain.

Water Exercise can help ease pain fatigue

Fatigue is often described as a general feeling of persistent tiredness or exhaustion. It's different from drowsiness, which is a need to sleep. When you are feeling fatigued, you have no motivation or energy. The water can loosen tight muscles and increase blood flow, which may help reduce fatigue. The resistance provided by the water builds strength and cardio endurance, generating more energy, which, over time, allows you to do more, fighting the feelings of fatigue in everyday life. In addition, exercising in the pool can also help to reduce stress levels and in turn help improve sleep quality and reduce fatigue. These benefits are amplified with heated water.

Water exercise can help with poor concentration as a result of pain

There are many different types of water exercise, but all involve using water to relax the body and mind. Water exercise can improve circulation, relieve stress, and ease muscle tension. It may also help to improve focus and concentration.

Water exercise can help with depression and anxiety associated with pain

Water exercise can help with depression and anxiety by providing a natural and calming environment. The sound of water can help soothe and relax the mind while being in water can help to release endorphins and improve mood. Water exercise can also help to reduce stress levels and provide a sense of peace and tranquillity.

Water exercise can help promote a healthy eating pattern Exercising in water can help regulate eating by alleviating control of hunger and cravings or promoting an appetite if yours is lost through feeling the effects of chronic pain. When you exercise in water, your body burns more calories than it does when you exercise on land, which can make the body send signals that you are hungry. This increased calorie burn can help to control your appetite and cravings and regulate a healthier eating pattern if the chronic pain makes you have an increased appetite.


An Aqua Treadmill is an innovative piece of aquatic equipment that enables exercise and manage chronic pain and its associated symptoms. It enables pain-free, low-impact exercise with minimal discomfort during and after the workout and doesn't aggravate symptoms. Aqua walking, also known as water walking or walking underwater, is an excellent exercise for people with chronic pain and fatigue. The water provides support and resistance, which can help reduce pain and increase strength, flexibility, and range of motion. The water also helps massage the muscles and joints, relieving stiffness and soreness. It is gentle on the body and accessible by people of all fitness levels. Aqua walking is recommended for someone with chronic pain and sleep problems because it can also help improve sleep quality by providing a state of relaxation and an exercise that naturally tires the body while the water relaxes the mind. Aqua walking can also help regulate appetite by improving metabolism and promoting satiety. Aqua walking or running is an excellent way to stay active in body and mind and improve your fitness level, which can help reduce pain over time.

An Aqua Bike can help alleviate the symptoms felt from pain and enable exercise with minimal aggravation. Aqua cycling is a fantastic way to challenge yourself without pain or impact on the joints. The low-impact nature of the exercise can help reduce stress on joints, while the water resistance can provide a good workout for the muscles. The warm water can also help relax the muscles and ease any pain or stiffness. For people with chronic pain or fatigue, aqua cycling can be a good option to stay active without exacerbating symptoms. In addition, warm water can help relax muscles and ease chronic pain. If you suffer from sleep problems, aqua cycling can burn much energy, inducing sleep. The water movement created from aqua cycling can also help massage the muscles and joints, which can relieve pain and help you sleep. The water can also help improve circulation, which can reduce inflammation and help to ease the pain, allowing for a more restful sleep process. For people with poor concentration, aqua cycling can also be a helpful way to focus on an activity and improve coordination. The moves to music on the bike improve focus, concentration, and coordination.

Aqua cycling is a type of water-based exercise that can provide a range of benefits for people with anxiety and pain. The gentle, low-impact movements of aqua cycling can help reduce pain and increase mobility. The exercise activates endorphins and feel-good hormones. The water's supportive environment can help reduce anxiety and promote relaxation. A group water cycling class with music is great fun and can foster new relationships, countering isolation and depression. Aqua cycling is a great way to regulate you're eating patterns. It helps you to burn calories and keep your metabolism high. The hydrostatic pressure on the abdominal region also helps improve your digestion.


Water exercise is a productive and constructive strategy for managing persistent pain and its symptoms. Its potency stems from the positive transformations it elicits across the body, brain, and nervous system, contributing to physical and psychological well-being. Crucially, aquatic exercise and physical activity offer a safe alternative, minimising potential harm and side effects associated with pain medications.

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