How Exercise Improves Pain Tolerance

Patient Expert

Although study after study has shown that exercise helps reduce fibromyalgia pain, we've had little understanding of why until now. Scientists have long known that during prolonged strenuous workouts, our bodies release endorphins, a kind of natural opiate that reduces pain and enables us to continue exercising. But they haven't known why (or even if) more moderate exercise would have a similar effect.

Study design and results

A new study published in  Medicine & Science in Sports & Exercise  helps to explain how even moderate exercise can affect our pain tolerance. Twenty-four young and healthy - but inactive - adults participated. They were divided into two groups: 12 who were interested in exercising and 12 who preferred not to exercise.

First, the Australian researchers determined the participants' pain thresholds - the point at which pain begins to be felt - by use of a probe that exerted pressure on their arms. Participants were told to say "stop" when the pressure went from being unpleasant to being painful.

Next, the researchers measured participants' pain tolerance - the maximum level of pain that a person is able to tolerate. This was done by wrapping a blood pressure cuff around the participants' upper arms while they squeezed a special testing device in their hands. As the cuff was progressively tightened, they were told to keep squeezing as long as they could.

Once the baseline pain thresholds and pain tolerance levels were established, participants in the exercise group began riding a stationary bicycle for 30 minutes, three times a week for six weeks. The non-exercise group continued with their lives as before.

At the end of the six weeks, participants' pain thresholds and pain tolerances were tested again. It was no surprise that the non-exercise group showed no changes in their pain response. However, the exercise group demonstrated a much greater ability to tolerate pain. It's interesting to note that their pain thresholds did not change; they still felt pain at the same point as before. But their ability to tolerate the pain had increased significantly.

In an article in  The New York Times  about this study, reporter Gretchen Reynolds contacted Matthew Jones, a researcher at the University of New South Wales who led the study. She noted, "Pain thresholds and tolerances were tested using people's arms, Mr. Jones pointed out, while the exercisers trained primarily their legs. Because the changes in pain response were evident in the exercisers' upper bodies, the findings intimate that 'something occurring in the brain was probably responsible for the change' in pain thresholds, Mr. Jones said."

My thoughts

I've always wondered just how exercise helps fibromyalgia. While this study didn't involve fibromyalgia patients and doesn't give us all the answers, it does give us some clues as to what is going on, which encourages me to keep trying to exercise more.

Despite the fact that so many studies have shown that exercise does help improve pain and other symptoms of fibromyalgia, many of us have found it difficult to begin and to stick with an exercise program because we're in so much pain to start with. Oftentimes, exercise seems to increase the pain - at least at first.

Personally, I've found that the key to exercising with fibromyalgia is to start very slowly and gradually increase . It may not seem like it's worth it if you can only exercise for a minute or two at first, but it really is. I would suggest you select a form of exercise you enjoy because you'll be more likely to stick with it. But if you can't think of anything else, walking is always a good way to start.

Note: Always check with your doctor before beginning any exercise program, particularly if you have chronic pain problems.

Image by "photostock" courtesy of


Jones, MD, et al. "Aerobic Training Increases Pain Tolerance in Healthy Individuals." Medicine & Science in Sports & Exercise. 2014 Aug;46(8):1640-7.

Reynolds, G. "How Exercise Helps Us Tolerate Pain." The New York Times, August 13, 2014.