For millions of Europeans living with chronic pain, the search for relief often ends at the pharmacy. But a new study from the University of Adelaide suggests that a walk in the park, a gentle yoga class, or a few sessions of tai chi might be just as effective as the pills in your medicine cabinet.
Researchers analysed 157 systematic reviews covering 2,736 randomised controlled trials and more than 220,000 participants. Their findings, published in the journal Pain, show that exercise can significantly reduce both acute and chronic pain across a wide range of conditions—from migraines and period cramps to back pain and arthritis.
On average, exercise reduced pain by about 1.1 points on a zero-to-10 scale. That may sound modest, but it is roughly 60% larger than the average relief reported for common pain medications in separate chronic pain trials. The effect was consistent across different types of exercise, including aerobic activity, strength training, and mind-body practices like pilates and yoga.
Less can be more
One of the most striking findings is that more exercise is not necessarily better. Low-intensity programs produced greater pain relief than moderate-to-vigorous activity, and shorter programs—around 12 weeks—showed larger effects than longer ones. Programs under 120 minutes per week were more effective than higher weekly durations that can feel unattainable for people living with chronic pain.
“Importantly, we found that more exercise wasn’t necessarily better. In fact, shorter-duration and lower-intensity programs showed greater reductions in pain, suggesting people may not need to exercise harder or for longer to experience meaningful benefits,” said lead researcher Ben Singh.
This is good news for those who find intense workouts daunting. A brisk 20-minute walk three times a week, or a gentle stretching routine, may be enough to make a difference.
Why exercise works
The mechanisms are both physiological and psychological. “When we exercise, our body releases chemicals including endorphins and serotonin that can help reduce how strongly we feel pain and increase our pain tolerance,” said Singh. Exercise also helps calm inflammation and changes the way the brain responds to pain, while improving mood—a crucial factor in chronic pain management.
These findings come at a time when Europe is grappling with an over-reliance on painkillers, particularly opioids. The continent has seen a rise in opioid prescriptions, and public health officials are seeking safer alternatives. The study’s senior researcher, Carol Maher, noted, “At a time when we’re looking for safe and effective ways to manage pain beyond medication, these findings provide strong evidence for making exercise a more routine part of pain care.”
From advice to prescription
Despite the evidence, exercise remains underused as a treatment for pain. It is not yet routine practice, and it is rarely prescribed with the same precision as medication. “Instead, people experiencing pain may be told to ‘stay active’, rather than being given a specific, evidence-based exercise program that considers what type of exercise to do, how hard to work and for how long,” added Singh.
The authors call on healthcare providers to move beyond generic advice and develop definitive guidance: not just whether exercise helps, but which exercises work for which patients, and how to prescribe them effectively. This is particularly relevant in Europe, where healthcare systems vary widely—from the NHS in the UK to the statutory health insurance in Germany—but all face the challenge of integrating lifestyle interventions into standard care.
Some European initiatives are already pointing the way. In Sweden, “exercise on prescription” has been a formal part of primary care since the early 2000s, with doctors writing out physical activity as a treatment. Similar programs exist in Finland and the Netherlands. The new study provides a stronger evidence base for expanding such approaches across the continent.
However, the researchers caution that exercise is not a universal solution. Its effects depend on individual factors such as the condition causing the pain, a person’s level of fitness, and adherence to the program. It may not eliminate pain entirely, but it can be a valuable tool in a holistic approach.
For those interested in the broader picture, Europe’s exercise boom masks deep inequalities in access, with wealthier urban areas enjoying better facilities than rural or disadvantaged regions. Ensuring that exercise-based pain care is accessible to all will be a key challenge for policymakers.
As the evidence mounts, the message is clear: before reaching for the painkillers, consider lacing up your trainers. Your body—and your mind—may thank you.
