As a physical therapist, I frequently meet people who have been experiencing pain for weeks or even months. When I ask what they’ve done to ease their discomfort, the answer is almost always the same: “lie down, ice, and take ibuprofen.” This response confirms a widespread belief in our society that rest is the primary treatment for persistent pain.
While rest and anti-inflammatory treatments may help reduce discomfort initially, these approaches are generally only recommended for new (acute) onset pain. It’s difficult to find evidence supporting rest for more than a few days as an effective recovery strategy. Most healthcare providers understand that the longer someone experiences pain, the less likely rest will help them recover from it.
One of the most important benefits of physical therapy is helping people with persistent pain begin safely moving again and gradually progress their activity level — rather than avoiding activity and waiting for rest to work.
Why Rest Can Make Pain Worse
The problem with relying on rest to reduce pain over time is tied to what happens when we stop moving. A body at rest experiences reduced circulation and diminished natural joint lubrication — both direct results of lack of motion. Rest also causes a reduction in heart rate and cardiac output. This combination means that the body’s tissues become deprived of blood and lubrication when movement stops.
This deprivation can lead to increased sensitivity in our sensory nerves, adaptive shortening of our muscles, and inadequate nutrition to our joint cartilage—all reactions that can contribute to more pain, not less.
The Dallas Bed Rest Study: A Cautionary Tale
An eye-opening example of how rest can negatively impact our health comes from the landmark 1966 Dallas Bed Rest study. This research is still cited today to emphasize the importance of getting people up and moving quickly after injury or surgery.
The study involved five healthy 20-year-old men who were placed on three weeks of complete bed rest. The results were startling: those three weeks of full rest caused the equivalent of 20 years of aging on their cardiovascular fitness, including raised heart rates, drops in maximal oxygen uptake, and increased body fat.
What makes this study even more remarkable is the 30-year follow-up. Researchers re-tested the same five subjects three decades later and found that the physical declines shown after just three weeks of bed rest were greater than even 30 years of natural aging.
On a positive note, after the men completed a six-month regular aerobic exercise program, the declines from 30 years of aging were reversed.
How Physical Therapy Uses Movement to Manage Pain
Physical therapists are skilled at helping people understand what types of activity are safe and when it’s beneficial to move beyond rest. A significant part of patient education centers on answering: “What’s safe for people to do, and why?”
Movement benefits the body’s tissues in multiple ways. Exercise and movement also “teach” and retrain the nervous system to calm down, which can be a crucial part of recovery after pain begins. Starting with gentle exercises and then progressing slowly and safely to improve strength and flexibility is effective in diminishing pain and increasing joint health and support.
Not all exercises are created equally. A combination of specific, targeted exercises along with instruction in a paced cardiovascular exercise program is often recommended for chronic pain management.
Flare-ups — temporary increases in pain — are often inevitable but not typically a sign of damage or re-injury. A physical therapist can guide you through a flare-up, helping you recover and work to prevent or limit future episodes.
Practical Movement Tips for Managing Chronic Pain
Chronic pain — pain that has persisted for more than three months — responds best to a consistent, daily exercise routine. The key is choosing movements that increase circulation, calm the nervous system (your body’s alarm system), and promote tissue health.
The good news? Your exercise routine doesn’t need to be extremely strenuous, high-impact, or designed to maximally challenge your heart rate to reduce pain.
A combination of the following can be highly effective:
- Daily walking programs
- Floor exercises
- Dumbbell or resistance band exercises
- Bodyweight strengthening exercises
- Stretching routines
Consistency is often what determines an exercise program’s effectiveness on pain. People experiencing chronic pain should consult with their local physical therapist for an assessment and discussion of goals before receiving a guided, comprehensive exercise and movement routine.
The Bottom Line: Movement Is Medicine
While rest may have its place in the initial days after injury, it’s not supported as a treatment for ongoing pain. Rest also comes with many negative side effects for our health and, at its worst, can actually increase pain.
The saying “movement is medicine” rings true in pain treatment. Movement and activity are now recommended globally — often as soon as the same day after many hospital procedures and surgeries. A body in motion is a healthy, resilient body, and research continues to support the need for people with chronic pain to get moving and stay active.
Exercises, including strength training and cardiovascular exercise, have growing support in the treatment of persistent pain. Schedule a physical therapy evaluation today to start moving safely and reduce your chronic pain.
Ready to take the first step toward pain relief?
As physical therapists, we know the importance of movement for overall health and well-being. From injury recovery to achieving optimal performance, our passion is to help every patient reach their goals and live an active, pain-free life. Get started with PT today!
