25/07/2026
Exercise: Are we making it harder than it needs to be?
For many people with persistent pain, the advice to "exercise more" can feel overwhelming. But new evidence suggests that effective pain management doesn't necessarily require high-intensity or long-duration exercise.
A new umbrella review—the highest level of evidence synthesis—combined findings from 157 systematic reviews, including more than 2,700 randomised controlled trials and over 221,000 participants, to examine the effects of exercise on pain.
What does this mean for clinical practice?
The review found that exercise consistently reduced pain across a wide range of conditions, including low back pain, neck pain, osteoarthritis, fibromyalgia, rheumatoid arthritis and other chronic musculoskeletal disorders. Benefits were also seen across different exercise approaches, including aerobic exercise, resistance training, Pilates, yoga and tai chi.
Perhaps the most clinically relevant finding was that lower-intensity exercise programmes lasting less than 12 weeks were associated with greater pain reduction than higher-intensity or longer programmes. The frequency of sessions and session length appeared to matter less.
For osteopaths, this reinforces an important message:
✅ Exercise doesn't need to be strenuous to be effective.
✅ Starting with achievable, lower-intensity programmes may improve patient confidence and adherence while still providing meaningful pain relief.
✅ Rather than searching for a single "best" exercise, clinicians can work collaboratively with patients to select activities they enjoy and are likely to continue—whether that's walking, resistance exercises, Pilates, yoga or tai chi.
This review also highlights the value of integrating exercise into routine pain management as part of a broader biopsychosocial approach. While manual therapy may help reduce symptoms and facilitate movement, supporting patients to become more physically active remains a key component of long-term care.
https://zurl.co/gfXLF
