Major Review Finds Exercise Matches Painkillers for Chronic Pain Relief

Whether stemming from migraines, menstrual cramps, or chronic conditions, pain may be managed as effectively through exercise as with common painkillers, according to a comprehensive new analysis.

Researchers at the University of Adelaide found that across a wide spectrum of conditions, exercise significantly reduces both acute and chronic pain. The study, published after analyzing 157 systematic reviews encompassing 2,736 randomized controlled trials and over 220,000 participants, provides robust evidence for integrating physical activity into standard pain care.

“At a time when we are seeking safe and effective ways to manage pain beyond medication, these findings provide strong evidence for making exercise a more routine part of pain care,” said senior researcher Carol Maher.

The investigation examined how the type, intensity, and duration of exercise influenced outcomes. Overall, exercise reduced pain by approximately 1.1 points on a zero-to-10 scale—a reduction roughly 60 percent greater than the average relief reported for common medications in separate chronic pain trials.

Notably, low-intensity exercise yielded greater pain relief than moderate-to-vigorous activity, and shorter programs of around 12 weeks showed larger effects than longer regimens. Programs under 120 minutes per week proved more effective than higher weekly volumes, which can feel unattainable for those living with persistent pain.

“Importantly, we found that more exercise wasn’t necessarily better,” said lead researcher Ben Singh. “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.”

Singh explained that physical activity triggers the release of chemicals such as endorphins and serotonin, which dampen pain perception and increase tolerance. Exercise also helps calm inflammation, alters how the brain processes pain signals, and improves mood.

Despite the evidence, the study highlights that exercise remains underutilized as a treatment. It is not yet routine practice and is rarely prescribed with the precision afforded to 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,” Singh added.

The authors argue that healthcare providers need definitive guidance—not just on whether exercise helps, but on which exercises work for specific patients and how to prescribe them effectively. They caution, however, that exercise should not be viewed as a universal cure or expected to eliminate pain entirely, as its efficacy depends on individual factors such as the underlying condition, fitness level, and program adherence.

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