Exercise Induced Hypoalgesia


Translation please…  “decrease in pain & sensitivity to pain after exercise”.

What is it about exercise that makes you feel good? We have all heard about runners high or have had a boost in mood after a gym workout (or at least have been told about it). But why and how does this occur?

Without getting too technical in neuroanatomy and neurophysiology we will discuss the mechanisms of why exercise is good for pain and how it can be an extremely effective tool in chronic pain management for everybody no matter your age, fitness (or lack of), and ability.

Lets dive in:


Descending pain inhibition, aka “top-down” pain control refers to how the brain actively decides whether we experience pain and how much we experience. During emergency & stressful situations the brain has adapted to decrease pain signals to the body because it believes that surviving is more important than feeling pain, so it effectively suppresses or tunes out pain.

The same mechanism is activated during exercise (the body deems it as “stressful”) so therefore the brain decides to turn the dial down on pain because it deems the exercise or activity as more important than the sensation of pain.

This pain inhibition system works extremely well and can be turned up or down! For example, marathon runners have it turned right up and as a result studies have shown their sensitivity to pain is greatly decreased compared to “normal” or non-marathon running people (you and me).

Unfortunately for some, like people with fibromyalgia the pain inhibition system can be turned way down as well, meaning we are much more sensitive to pain.


Exercise and physical activity can help with pain by altering the immune system. This can occur by altering macrophages (inflammatory cells in the blood) to be more likely to release ant-inflammatory substances rather than release inflammatory metabolites. Secondly exercise can reduce the number of inflammatory cytokines that naturally occur in the blood but which can be more numerous in people who have fibromyalgia.


This in its simplest form means “pain inhibits pain” or being exposed to pain often means we are better at dealing with it when it occurs. This concept has been studied for years, an example for simplicity is if you put your hand in freezing water for 30 seconds and measure how much pain you experience, then wait 5 minutes and do the same again, time and time again you are shown to experience less pain the second time around.

The same concept applies with exercises, experiencing short term pain while exercising, likely means the next time you do that exercise your pain will be less, and so on and so on.

But what does all this mean? In short exercise has numerous positive health effects & it is extremely good at helping pain if done consistently. It is quite literally the body’s own pain medication.

It is important to note that all exercise should be graded to the ability of the person and be modified due to injuries & musculoskeletal conditions.

So, it is always best to get assessed properly by a Physiotherapist or Chiropractor before going full steam ahead into exercise just because the evidence states it helps with pain. At Perth Allied Health Clinic our team can help you in this process.

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