Best Exercises for People With Chronic Pain, According to Personal Trainers

Living with chronic pain isn’t easy in any part of your life. However, the good news is you don’t have to forgo your fitness routine. In fact, by committing to a regular workout routine, you’re not only improving your health but your body will feel better too.

“Exercise has been called the miracle drug because of the countless benefits to the human body and often recommended as a major component in the management of numerous disorders,” Christopher Harper, PT, DPT, OCS, tells SheKnows. “Exercise improves blood flow to the brain and feeds the growth of new blood vessels and brain cells. Exercise therapy is also the most widely used type of conservative treatment for pain, with systematic reviews advocating exercise therapy as effective in the management of chronic pain.”

Harper points out that it’s important for an individual to consult with their medical team before engaging in any exercise. He also recommends participating in a fitness program that is tailored to your own needs and health. The following exercises can be a good starting point as you research and consult with your support system/health team and have been recommended by an array of personal trainers and medical health professionals for those managing chronic pain.

Mix It Up

Jillian Michaels, health and fitness expert and creator of The Jillian Michaels Fitness App

“When dealing with chronic pain I always recommend running any exercise regimen past your doctor.  Every condition is different and while fitness can be extremely helpful in reducing chronic pain it can also exacerbate the problems greatly if done incorrectly or if you are engaging in a type of fitness that is simply not conducive to pain management. 

In my experience, when I owned a sports medicine facility and worked directly with physical therapists and physiatrists, there are certain modalities that help to increase blood flow, improve mobility, and build strength that aren’t going to increase inflammation in the body. 

Things like restorative yoga, tai chi, mat pilates, swimming or water exercises, light cycling, and even walking programs have been shown to help with conditions like fibromyalgia and rheumatoid arthritis, etc. I am not a fan of recommending “a few exercises” because the key is a fitness regimen that is consistent and has a variety of exercises within the modality. You don’t want to do the same exercises repeatedly because it can actually cause repetitive stress, which leads to inflammation.  So consider a program for beginners that incorporates the above mentioned modalities with the approval of your doctor.” 

Focus on core strength and flexibility

Dr. Josh H Glass, certified Chiropractic Sports Practitioner, 2012 & 2016 USA Olympic Team Sports Medicine Staff

“The two things that anyone with pain can start with is improving core strength and flexibility. Core muscles provide stability and support to the spine and pelvis, and the stronger they are the less likely chronic pain is to occur. Of course, always consult with your sports medicine physician if your pain persists or becomes worse. With any of these stretches and core exercises, stop if the pain increases.”

Some basic core exercises to start with at home, include:

  • Pelvic Tilt: Lying on your back, head on the floor, contract and push your low back into the ground and tilt our pelvis up. Start with 5 second counts, 5 -10 times. You can increase the hold time as you get used to it.
  • Bridging: Lying on your back, head on the floor, knees bent and feet flat on the floor. Lift your pelvis off the ground and contract your glute muscles. Same 5 second hold, 5 – 10 times.
  • Press up: Lying on stomach, hands at side at shoulder level, push up torso, keeping pelvis on the ground, basically a half push up. Five second hold, 5 – 10 times.

“Improving flexibility will also aid in reducing chronic pain, by improving your posture and movement. Stretches should never hurt. You should stop any stretch that does. Stretching should be done multiple times a day. After any exercise and in the evening are ideal times.” Short holds, 3 – 5 seconds long, are safest, says Glass, but longer holds are okay, as long as there is no pain. Do in sets of 5 – 10. Here are a few basic stretches that he recommends:

  • Hamstrings: Lying on back, use a rope or towel to loop over your foot and pull straightened (knee locked) leg up.
  • Hip Flexors (Psoas): Kneeling on a soft surface, in a lunge position, lean forward and push pelvis forward, this is stretching your hip flexor of the knee that is down. You should feel the stretch across your belt line. Reaching your hand up in the air on the leg your stretching will help.
  • Glutes: Lying on back, bring knees to chest and pull with arms. Can be done with legs separately and together.

Strengthen your posterior chain too

 K. Aleisha Fetters, MS, CSCS, a certified strength conditioning specialist, online coach, and author of Fitness Hacks for Over 50. 

“Regular movement and exercise can be incredibly beneficial in easing symptoms of, and in some cases, treating, many forms of chronic pain. Strengthening the muscles of the core, glutes, and back can help reduce lower back pain. For example, the spinal erectors act as scaffolding for the spine. Fortify that structure and the compressive forces on the spine will decrease,” she tells SheKnows. “Strengthening muscles around any joint, such an arthritic knee similarly takes excess stress off of the joint. It also promotes lubrication of the joints, increases oxygen-rich blood flow to the area, and can improve joint mechanics. Research consistently shows that multiple forms of exercise can slow the progression of diabetic neuropathy and pain.”

  • Dead Bug

Benefits: Strengthens the core muscles and helps alleviate the chronic posterior tilt of the pelvis, which is a large contributor to lower back pain and even hamstring tightness. You can perform it on the floor or even on top of your bed, based on mobility and comfort.

Instructions: Lie face up with your arms and legs extended toward the ceiling, knees straight or bent. Press your lower back into the floor and brace your core. From here, while maintaining this back-to-the-floor position, lower one arm toward the floor above your head and your opposite leg toward the floor. You can straighten your knee as you do so to increase the load on your core. Lead with your heel. Pause when both are as close to parallel with the floor as possible without your lower back losing contact with the floor. Squeeze your core to draw your arm and leg back to start. Repeat on the opposite side. That’s one rep.

  • Bird Dog

Benefits: The core includes your back. This exercise hits all 360 degrees of the torso to strengthen the transverse abdominis as well as erector spinae to address muscle weaknesses and postural issues that may be contributing to back pain.

Instructions: Get on your hands and knees. Your shoulders should be directly over your hands and your hips directly over your hips. Brace your core to tuck your pelvis so that you are in a flat tabletop position. Here, the bottom of your ribs should be pointed to your hips, rather than jutting down toward the floor. From here, squeeze through your back and glutes to raise one arm and your opposite leg, leading with your heel, until they’re parallel to the floor. Keep your torso stationary as you do so. Pause, then slowly lower your arm and leg to return to start. Repeat on the opposite side. That’s one rep. Prioritize maintaining a completely still torso over the height of each arm and leg raise. If this feels easy, you need to double-check your setup!

  • I, Y, T Raise

Benefits: Training the upper back does so many great things for the entire body, improving posture, spinal alignment, and helping to correct issues throughout the kinetic chain. 

Instructions: Lie face down with your arms extended in front of you and positioned so that your thumbs point up toward the ceiling. This is the starting position. Pinch your shoulder blades together to raise your arms as high as possible without letting your chest leave the floor, then slowly and with control, return your arms to start. 

Perform with your arms positioned in an I (arms straight overhead), a Y (arms diagonally overhead), and T (arms straight out to the sides), all with your thumbs pointing up. All motion should come from between your shoulder blades.”

As is the case with anyone, says Fetters, it’s important for people with chronic pain to listen to their body and choose exercises that are right for their unique needs. “Exercise can feel challenging, and sometimes even uncomfortable as muscle fatigue, but there’s a definite difference between the feeling of a muscle working and pain. Anything that’s experienced as sharp, stabbing, sudden, or occurs in or around a joint, as opposed to in the belly of the muscle, is reason to take pause and reassess both your exercise technique and selection.”

A version of this story was published May 2020.

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