Exercise Without Fear—Movement Strategies for Chronic Pain

For many people living with chronic pain, the idea of exercising can create fear: “will this hurt me further?” You may worry that movement will make your pain worse or that you’ll do something “wrong” and re-injure yourself. It’s completely normal to feel hesitant, but avoiding movement altogether can actually make pain worse over time. 

Kinesiophobia is the term used to describe this fear of movement or exercise. It’s a common occurrence for people with chronic pain. Working through and coping with kinesiophobia is an important step towards becoming comfortable with movement. Part of this involves reframing exercise—it doesn’t have to be intense or painful.

This article will explore where the fear of movement, or kinesiophobia, comes from and how to cope with it. Further, we will suggest some safe, low-impact exercises that you can get started with.

How Exercise Helps Chronic Pain

Exercise and movement offer a range of benefits for people with chronic pain, including:

• Improved blood flow: Movement increases circulation, bringing oxygen and nutrients to tissues and reducing stiffness.
• Endorphin release: Physical activity triggers the release of endorphins, your body’s natural pain-relieving chemicals .
• Increased strength and support: Stronger muscles reduce the strain on joints and support better posture, which can alleviate pain.
• Mood enhancement: Exercise has been shown to reduce anxiety and depression, both of which can intensify pain.

For conditions like arthritis, fibromyalgia, and chronic back pain, consistent, low-impact movement can significantly improve pain management and overall function.

Addressing Common Fears About Exercise With Pain

“Will Exercise Make My Pain Worse?”
It’s natural to feel nervous about movement if you’re already in pain. However, there’s a difference between “good pain”, like mild muscle soreness from exercise, and “bad pain,” such as sharp or shooting discomfort. Starting slowly and pacing yourself allows you to strengthen your body without overwhelming it.

“I Don’t Know Where to Start.”
Beginning an exercise routine doesn’t have to be diving into a high-intensity program. Physical therapists or certified instructors can guide you toward safe, effective movements tailored to your needs. The key is finding activities that suit your abilities and gradually increasing intensity over time.

Safe Movement Strategies for People with Chronic Pain

1. Start Slow with Low-Impact Activities
   Gentle exercises like walking, swimming, or stationary biking are great for improving circulation and building endurance without overloading your joints. Start with just 5–10 minutes daily and increase as you feel comfortable.
2. Incorporate Stretching and Mobility Work
   Stretching keeps your joints flexible and reduces stiffness. Simple exercises like neck stretches, seated forward bends, or yoga poses like Cat-Cow can help maintain mobility and reduce pain.
3. Strengthen with Bodyweight Exercises
   Strengthening your muscles supports your joints and relieves strain. Begin with simple moves like wall push-ups, chair squats, or light resistance band work.
4. Try Mindful Movement Practices
   Tai chi, yoga, and pilates combine physical activity with relaxation techniques. These practices can improve balance, reduce stress, and release tension.
5. Consistency Over Intensity
   Short, frequent sessions are more effective than infrequent, high-intensity workouts. Even 10 minutes a day can lead to noticeable improvements over time.

Staying Motivated and Safe

• Listen to Your Body: Learn to recognize the difference between pushing yourself and overdoing it. Rest when needed, but avoid long periods of inactivity.
• Set Realistic Goals: Focus on small, achievable milestones, like walking a few extra minutes each week.
• Build a Support System: Join a class, find an exercise buddy, or participate in online communities to stay motivated and share experiences. Connecting with someone who can understand the fear of movement and pain will help you feel heard and supported. 
• Celebrate Successes: Whether it’s walking a little farther or experiencing less pain during daily activities, every success is worth acknowledging.
• Find the Fun: Reflect on what kind of movement is fun to you. Engaging in a fun activity, like dance or aqua fit, can help you stay motivated.

Conclusion

Exercise doesn’t have to be scary or intimidating. By taking small, manageable steps, you can rebuild your confidence in movement and improve your quality of life. 

Start with just five minutes of a gentle exercise today—stretching, walking, or breathing deeply—and notice how your body feels. Remember, even small changes can have a big impact over time.

If you’d like to learn more about changing your thoughts and behaviors and escaping chronic pain cycles, check out our free CBT for Chronic Pain course on the I-Engage Academy. It includes lessons on pacing, setting goals, low-impact exercise, relaxation, and shifting your mindset: all factors involved in becoming more comfortable with movement despite pain.

References

Arthritis Foundation. (n.d.). The benefits of exercise for osteaarthritis. Retrieved from: here.

Büssing, A., et al. (2012). Effects of yoga on chronic pain: a meta-analysis. The Clinical Journal of Pain, 28(8), 787–796.

Chou, R., et al. (2017). Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Annals of Internal Medicine, 166(7), 514–530.

Geneen, L. J., et al. (2017). Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database of Systematic Reviews, Issue 4.

National Institute on Aging. (2020). Exercise and physical activity: Getting fit for life.

Russo, M. A., Santarelli, D. M., & O’Rourke, D. (2017). The physiological effects of slow breathing in the healthy human. Breathe, 13(4), 298–309.