ABSTRACT

Patients with chronic pain are more likely to be sedentary and less likely to engage in regular physical activity or exercise than their healthy peers. Although individuals with chronic pain report many of the same obstacles to physical activity as healthy people, they also often attribute their lack of activity to disability or pain as a result of their condition and a fear of exacerbating symptoms. This perspective could be particularly detrimental for these individuals as their low levels of activity and large amounts of sedentary time put them at a greater risk for worsening their disability (McCracken & Samuel, 2007), as well as other medical conditions such as heart disease, cancer, and stroke. This process has been characterized by some as a vicious cycle; these patients are inactive, at least in part, as a result of their pain condition, which leads to greater disability, which in turn decreases the likelihood of them being physically active (Leeuw et al., 2007). The relatively low level of activity in these patients is especially troubling when considering the large and growing body of evidence demonstrating that exercise and increased levels of daily physical activity can provide benefits to individuals with chronic pain beyond enhanced physical fitness. The benefits of regular exercise for these patients may include improvements in pain symptoms, physical and functional capacity, fatigue, anxiety, depressed mood, and quality of life. For low to moderate intensity prescriptions, the consensus appears to be that chronic pain patients can engage in exercise safely and without fear of exacerbating symptoms. Clinicians, for the most part, no longer subscribe to the view that rest and activity avoidance are the best methods of managing chronic pain symptoms. In fact, following decades of research, a recommendation for exercise or increased physical activity has become a standard element of multicomponent therapies for all manner of chronic pain conditions (Iversen, 2012).