How Exercise Can Improve Mental Health and Chronic Pain

We know that regular exercise therapy in the form of a combination of stretching and strengthening gradually helps improve functionality and resolve chronic pain. But exercise also has powerful effects on mental health.

Published Date: Sep 9, 2021
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Dr. Kevin Hanson, PT, DPT
Outside adventurer, mountain biker, gardener, reader and relaxer.
Doctor of Physical Therapy, outside adventurer, mountain biker, gardener, reader, and relaxer.

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In recent years, we’ve learned a lot about the connection between chronic pain and mental health. We’re still learning, but we know that people who report chronic pain also experience more stress, anxiety, and depression. Among people with chronic pain, 30% to 50% also have depression, and even more notably, 65% of those with depression have chronic pain.

This is because chronic pain and depression have similar pathways in the brain. Increased pain leads to heightened depression. At the same time, depression or anxiety can amplify how the brain perceives pain. Study after study shows there’s a huge overlap between mental health and chronic pain. This is often referred to as the “depression–pain dyad” or, because it’s so common, “depression–pain syndrome.”

However, regular exercise can improve both mental and physical health. In a study involving 1.2 million participants, researchers from the University of Oxford and Yale University studied the relationship between physical exercise and self-reported mental health. People who exercised reported 44% fewer days of poor mental health.

The positive effect of exercise on mental health was demonstrated across all groups in this study. Differences in age, race, gender, household income, and education level didn’t matter. And the researchers didn’t stop there. Here’s what else they found:

- Any kind of exercise is better than no exercise.

Forty-five minutes of exercise three to five times per week is optimal. For some, exercising this much is not doable. But the message is clear: do what you can. The conclusion that any exercise is better than no exercise is encouraging. Exercising in the way that works for you is a powerful tool to help you feel better—both physically and mentally.

- More exercise is not always better.

People who exercised more than twenty-three times per month or more than ninety minutes per week reported lower mental health ratings. This is a great reminder that for some people, too much of anything (even exercise!) can add stress. It’s important to take time for recovery and other activities. This gives your body a break and allows it to adapt to your exercise routine. Your mental health benefits, and you can keep moving toward your goals.

- Personal connection is important.

People who engaged in team sports and cycling showed the lowest mental health burden. And this was true for all groups of participants, including those who had been diagnosed with depression in the past. Team sports, exercising with friends, and virtual exercise groups allow you to create connections with other people. And studies show that coupling the benefits of exercise and social interaction is an ultra-powerful tool.

Why does exercise help reduce depression and anxiety?

We know that regular exercise therapy in the form of a combination of stretching and strengthening gradually helps improve functionality and resolve chronic pain. But exercise also has powerful effects on mental health. Regular exercise may ease depression and anxiety by releasing feel-good endorphins and other brain chemicals that enhance your sense of well-being. Exercise—whether it’s getting outside for a job, playing team sports with friends, or taking a group aerobics class—can also help people put their worries aside and avoid negative thoughts that can breed depression and anxiety.

The connection between exercise and better mental health is clear: exercise can reduce stress, anxiety, and depression. This often lowers the level of pain you experience. Less pain allows for more freedom of movement. Freedom of movement makes it possible to do the things you love.No matter what you’re going through, choosing exercise that works for you is the choice that will help you move forward. Here are a seven ways to make exercise part of your daily routine and help break the cycle of chronic pain and depression or anxiety:

  1. Get up and stretch every few hours during your workday. Here are five ways to incorporate movement in your workday.

  2. Try yoga after work as a way to decompress and stretch. Here are four beginner yoga poses to relieve back pain.

  3. Try going for a twenty-minute walk or run a few times a week or on a longer hike or bike ride on the weekend.

  4. If you are interested in vigorous activity, sign up for a group exercise class or team sport that meets at least once or twice a week.

  5. Set an exercise goal that suits you, whether it’s doing yoga every day or running a half marathon.

  6. Find an exercise buddy to keep you accountable and make it social!

  7. Finally, don’t overdo it. Gradually build up to it. Remember, too much exercise can cause stress, so you’ll want to find the right balance.

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