Exercise as Analgesia in Chronic Musculoskeletal Pain: A Review of Effect Size and Durability Across the Trial Literature
DOI:
https://doi.org/10.5281/zenodo.22548375Keywords:
Exercise-induced hypoalgesia, Chronic pain, Exercise therapy, Effect size, Osteoarthritis, FibromyalgiaAbstract
Exercise reliably reduces pain sensitivity acutely in laboratory settings, a phenomenon known as
exercise-induced hypoalgesia, and this same logic underpins exercise's status as first-line,
guideline-recommended treatment for chronic low back pain, osteoarthritis, fibromyalgia, and chronic
neck pain. What is less consistently appreciated is how the reported effect sizes compare across these
conditions, and how durable the analgesic benefit is once a supervised exercise programme ends. This
review synthesises the Cochrane and primary systematic-review literature on exercise for chronic
musculoskeletal pain alongside the smaller mechanistic literature on exercise-induced hypoalgesia, to
characterise both the typical effect-size range across conditions and the pattern of attenuation over
follow-up. A formal statistical meta-analysis pooling raw trial data was not undertaken; this review
instead synthesises the effect estimates and conclusions already reported in the cited published systematic
reviews and meta-analyses.
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