Movement and Chronic Pain: Rebuild Trust in Your Body

Living with chronic pain changes how you experience your body, and how you relate to motion. Over time, what once felt natural can become uncertain or even frightening. Many people describe being caught between two fears: the fear of making pain worse and the fear of losing even more of their lives if they stop moving.

That tension is completely normal. Pain is designed to protect us. However, when it lasts for months or years, the nervous system can stay on alert even after the tissues have healed. As a result, the body continues to react as if danger is still present. That’s why movement and chronic pain often become intertwined, one feeding the other in a cycle of fear and avoidance. In this article, we’ll look at why movement can feel risky, what science says about exercise in chronic pain and how to rebuild trust in your body through safe, steady activity.

Before we get into that, let me tell you what it looked like in my life.

My Story with Movement

The other day I was in a group session for people with chronic pain, and something struck me to the core. One woman asked how she could start moving again. It wasn’t so much the question, but the way she asked it: the fear in her voice blended with hope. The courage it took to even think about moving more and to actually pose that question. The hope she put in it, thinking that maybe, just maybe, there was a way to move without making it worse, without breaking her body even further. That moment made me want to write about movement and chronic pain right away.

From as far back as I can remember, movement had always been my way of being in the world. As a child and teenager, I was never still – football, badminton, table tennis, dancing – anything that meant being outside, moving. It wasn’t exercise; it was joy. It was how I felt free. Later on, I discovered the wonders of being in the water; backstroke was my favourite, but aqua gym also nailed it. Tennis was a marvellous way to connect with new friends. Being in motion made sense to me. It gave me energy, calm and balance.

So when pain entered my life, it clashed with everything that once made me feel alive. At first, I couldn’t accept feeling discomfort every time I moved, so I began removing movement from my days, cautiously, bit by bit. Movements and positions that once felt natural began to seem risky, and I slowly lost curiosity about my body. I could still stretch, but never without discomfort. My goal became to feel at ease again, and I believed the only way to achieve that was by avoiding anything that might make it worse. During the first four months after my “stuck” episode, my world kept narrowing.

As the discomfort spread, avoidance took over completely. Suddenly, I was analysing every gesture. Sitting became the hardest thing as it was triggering the strongest sensations. I could walk for short periods, but I spent most of my time lying down. Exercise, in the way I once knew it, felt impossible. The freedom of movement turned into fear of movement. I remember going to an osteopath and, when it came to taking off my shoes or lacing them, I didn’t know how to sit. The firm belief that bending would most likely break my back made me carefully assess even the simplest actions.

Sometimes, when there was no way out of a plan or event, I would take a lot of pills to make sure that movement would be possible without pain. Of course, it didn’t work flawlessly, but for a few hours, I could feel “normal” again. The next day, I paid for it in full measure.

Close to where I live there’s an outdoor gym, and I remember watching older people using those machines and feeling sadness that I couldn’t even imagine myself doing that. Seeing people running, playing, training around me was a constant reminder that I was not who I used to be.

For a long time, my world became smaller. I kept choosing the same coffee shop because it had comfortable wicker chairs and small pillows that supported my lower back. During the day I stopped reading; I only read before bed, propped up by a thousand pillows. Because I could not predict how my body would react, I stopped travelling or planning outings. I lived in constant negotiation with activity: when, how, how much, for how long. So the plan was simple: only once the pain was gone would life begin again – all those things could wait until then. I didn’t want people to see this new version of me; I wanted to wait until the symptoms disappeared and show up as the person they used to know.

Since I was little, I’ve been afraid of the dark. Now my biggest fear was wooden chairs: the ones with straight backs and no pillows. I remember arriving somewhere and checking the seats through the window first. Panic and pain were building up at the mere sight of it. Ah, and benches. Jesus Christ Almighty, and I’m not even religious.
But if I spotted a “good” chair – soft, curved – my whole body relaxed. 

In 2023, however, that fear flipped into rebellion. After a year of near-complete isolation, without a social life, plans or much contact with people, being so careful exhausted me. Around that time, I had just started taking morphine, barely a month into the treatment, when I met my boyfriend. I was eager, almost desperate, to feel alive again. Mentally, I was ready to do everything I had been avoiding: go out, move freely, stay up late, live. I wanted to prove that I was still the same person, capable of joy and spontaneity.

So I did. I pushed through the pain with medication and willpower; more medication than willpower. I wasn’t hiding from my partner that I was in pain, but I kept saying yes to everything and only stopped when I was on the edge of collapse. The synthetic morphine was doing its little chemistry game, muting the alarms my body was desperately trying to send. I ignored them all. I wasn’t just trying to move; I was chasing the life I thought I had lost. But inevitably, every time I crossed that line, which was often, my body stopped me. Sometimes for days, sometimes for weeks.

Those crashes taught me something I hadn’t wanted to learn: forcing activity is not the same as restoring it. They also showed me that taking opioids for a long time, apart from the risk of addiction, can create a false sense of relief and joy.

Still, the lucky part was that a bit before those frenzied times, with the help of a specialist, I had already begun exercising again. But because I wanted things to change overnight, I pushed too hard, how familiar – and soon felt I couldn’t keep going. That wasn’t true. I could just slower, smaller, differently. I didn’t want to accept those terms, so I landed back at baseline, again and again.

Eventually, the actual change came when I learned that I was dealing with chronic pain. It took me more than six months to assimilate that. Through education, I understood that resisting the sensations only made them worse. And by “things,” I mean pain and anxiety. I began moving in order to feel safe again; not to prove something.

Of the exercises I learned over two years, I kept the ones that best fit my body and mind. I created a safe, empowering set of movements. My everyday friends: a thick mat, two elastic cords, two one-kilogram weights and a push-up bar (I use it to release tension in my neck). Some days I use all of them in one session; other days it’s just the mat with gentle mobility and pain-relief work. I move within the limits my body allows each day. I remember what one of my girlfriends said when her baby was throwing tantrums or pinching people and laughing: “If it hurts, it is not funny.”

Most days, I exercise for about 30 minutes. Some days it’s 20, or I swap it for a walk or another kind of activity. On the days when I can’t do much, I remind myself to trust the process. Progress rarely moves in a straight line.

Now, being active is not a risk. It’s a way of teaching safety to my nervous system. I still feel pain, I still get scared, but I trust my body.

And when I think back to that woman in the group, asking how she could start moving again, I understand her completely. I didn’t have a perfect answer for her, only the truth I had learned myself: sometimes, the hardest part isn’t starting again. It’s believing you still can.

Why Movement Feels Risky When You Live With Pain

Long-lasting pain can make the body’s alarm system overly sensitive. Normal actions like walking, reaching, bending can feel threatening even when no injury is present. That’s one reason movement and chronic pain often feed each other; your brain is trying to protect you, but it ends up keeping you stuck and misreads safe signals from joints and muscles as danger. The result: pain, tension or fear of movement itself. Sometimes even a short walk or stretch can cause sharp sensations.

Science also explains why these fears feel so powerful. Expecting pain can actually heighten how strongly it’s felt; a process known as the nocebo effect. When the brain anticipates danger, it increases sensitivity across the pain system. The good news is that this response can reverse: safe, gradual activity teaches the brain that motion is not a threat, helping sensitivity settle.

Recognising these fears is essential. They’re not weaknesses; they’re protection gone into overdrive. Ultimately, learning to calm that alarm system through consistent, gentle movement helps your body feel safe again. 

How Pain Changes the Way We Move

Chronic pain reshapes movement habits. Muscles brace to protect sore areas, posture becomes guarded, and balance can shift as the body avoids certain ranges. These protective patterns, helpful at first, often create new stiffness and effort that make ordinary tasks feel less steady.

The brain learns these patterns too. Movements that were once automatic now trigger hesitation because the brain has paired them with discomfort (kinesiophobia). That isn’t weakness; it’s learned protection. The catch is that prolonged guarding keeps the system on “watch,” so even simple actions feel harder than they are.

The way out is practice that reduces threat, not performance pressure. Short, well-tolerated actions – one slow reach, a brief walk, an easy turn – help the body use less bracing and more coordination. Repetition under calm conditions teaches smoother control and ease, step by step.

For how low energy affects coordination and motivation, see Fatigue & Brain Fog.

What Science Tells Us About Exercise and Chronic Pain

Across decades of research, one conclusion keeps appearing: movement and chronic pain are not opposites. Gradual, consistent activity is one of the most effective ways to stabilise an oversensitive nervous system and rebuild confidence in the body.

When pain persists for months or years, it’s not always a sign of damage. The brain and spinal cord can stay in protection mode, misreading normal signals as danger; an alarm that never fully switches off. The encouraging part is that this can change. Regular, tolerable movement helps the body and brain cooperate again, showing the system that ordinary activity is safe.

How Exercise Supports Recovery

Research highlights several ways in which physical activity promotes recovery; not only by strengthening muscles but also by recalibrating how the body interprets sensations:

Recalibrating pain signals. Safe, repeated motion teaches the brain to interpret sensory input more accurately. Over time, everyday activity stops triggering false alarms: a process known as neuroplastic retraining.
Activating natural pain relief. Exercise releases endorphins and endocannabinoids, chemicals that reduce discomfort and lift mood by influencing pain-processing regions in the brain.
Improving circulation and tissue health. Movement enhances blood flow and oxygen delivery, supporting repair and lowering inflammation.
Balancing stress and mood. Regular activity helps regulate cortisol and serotonin levels, leading to better sleep, calmer emotions and steadier energy.
Restoring body awareness. Many people disconnect from their bodies after months of guarding against pain. Gentle motion rebuilds proprioception – awareness of body position – and replaces fear with familiarity.
Reinforcing self-trust. Each minor success, like a short walk or simple stretch, shows the brain that movement can happen without harm; rebuilding confidence step by step.

What Happens in the Muscles During Long-Term Pain

When movement decreases for extended periods, muscles adapt; but in ways that make pain worse. Fibres stiffen and shorten, losing flexibility. Circulation slows, and tissues can feel heavy or tight even at rest. Some muscles remain in partial contraction, while others weaken from under use, creating imbalances that reinforce fatigue and sensitivity.

Fortunately, these changes are reversible. Gradual motion restores elasticity, improves blood flow and helps deep stabilising and surface muscles coordinate again. Over time, rigidity gives way to smoother, more efficient movement, proof that recovery is possible.

Physical recovery often starts in the muscles, but motivation begins in the mind. Once the body is ready to move again, the next challenge is helping the brain want to move, and that’s where emotional conditioning makes all the difference.

Making Movement Feel Good Again

When you live with chronic pain, motivation to move rarely comes from discipline or willpower alone; it grows from how your brain connects movement with reward and safety.

Recent research shows that pairing activity with something genuinely enjoyable – such as music, nature or a calm environment – activates the brain’s reward pathways. These positive signals help the nervous system associate movement with calm instead of threat.

I’ve noticed this in my routine. When I exercise, I listen to my favourite podcast, and I’m always excited to start. I turn off the lights and let only the morning light filter in, so a calm atmosphere forms instantly. I usually face a window while moving; somehow it helps me breathe better and stay grounded. These small rituals make the session feel like my space, my time, not another task to complete.

This process, known as positive conditioning, teaches the brain to expect comfort rather than danger. Each enjoyable experience of movement tells your system, “This is safe. This feels good.” Gradually, the body responds with less tension and more ease.

It’s not about pushing through pain, but about helping the brain rewrite its associations. For example, walking while listening to your favourite song, stretching by a sunny window, or moving in water can all strengthen the sense that activity can be gentle and even soothing. Over time, this reward-safety connection makes it easier to move regularly; not because you must, but because your body wants to.

Therapists and researchers call this the reward–safety link: the way positive emotion and physical motion combine to reduce fear and build consistency. It’s one of the most effective ways to restore natural motivation and help the brain trust the body again.

Evidence: Journal of Physiotherapy, 2025

Finding the Right Kind of Activity

No single form of exercise suits everyone with chronic pain. The best outcomes come from gradual, meaningful, and sustainable motion rather than intensity. What matters most is how the activity feels, not how it looks.

Aerobic activities such as walking, swimming or cycling improve endurance and heart health without stressing joints.
Light strength work supports posture and joint stability, reducing tension.
Yoga or tai chi combines breath and balance, improving flexibility while calming the nervous system.
Water-based options ease movement by reducing load and pressure.
Somatic approaches, like the Feldenkrais Method, focus on awareness and coordination to release unnecessary effort.

Start where you are. For some, that means five minutes of motion; for others, a short walk or brief session. What counts is consistency over intensity, showing up regularly at a pace that feels safe. Each time you move, you’re not just exercising; you’re strengthening the vital partnership between movement and chronic pain, showing your body that they can coexist in balance.

Awareness in Motion – Feldenkrais Method

The other day, during a somatic awareness workshop, the instructor guided us through a series of gentle exercises. The one that made the biggest difference for me was surprisingly simple: keeping my eyes fixed straight ahead while slowly turning my head. It was fascinating to notice how, while my brain was busy coordinating the eyes and head, the pain in my neck eased. The movement became smoother and less tense. Then I began yawning, over and over, and by the end of the session, I felt sleepy, with a light headache, but much less stiffness in my neck.

You see, the area I struggle most to calm and stretch is my neck. It’s the first to react to stress, an aggressive massage or a bad night’s sleep. So for me, being able to relax the neck, even if just for a bit, was gold. It goes without saying, but I’ll say it anyway, that I’ve included this exercise in my everyday routine.

This practice is part of the Feldenkrais Method, a somatic education system that helps the nervous system rediscover easier, safer ways to move through awareness. Instead of forcing the body, it uses slow, mindful exploration to improve coordination and release unnecessary effort. The focus is on sensing, noticing how slight adjustments affect comfort and motion, and allowing the body to reorganize itself naturally.

Many people use the Feldenkrais Method in pain rehabilitation and nervous system retraining because it helps restore a sense of safety in action. By paying attention to how we move, it teaches that motion doesn’t have to mean discomfort.

Rather than “doing” an exercise, it invites exploration:  How small can I move?  What changes if I focus on breathing, my shoulders or the space behind me?

By replacing effort with curiosity, the body learns again that moving can be safe and freeing.

Visualization: Rehearsing Movement in the Mind

If motion still feels unsafe, you can begin with visualization, also called motor imagery. Research shows that imagining a movement activates many of the same brain areas as performing it. By mentally rehearsing motion in a calm, safe state, you help your nervous system relearn that movement is possible before you physically move.

Find a comfortable position and take a few slow breaths. Picture yourself walking, stretching or floating in water; whatever feels natural and safe. Focus on how your body would move, not how it should move. The goal isn’t to “push” through; it’s giving your brain a calm reference for safety and control. Over time, this simple mental practice helps your body follow more easily when it’s ready to move again. 

Four Gentle Approaches to Movement

These four approaches offer a mindset that makes activity sustainable with chronic pain. You can apply them to any form of motion, from stretching in bed to taking a short walk.

Explore. Begin with curiosity, not performance. Notice what your body can do today: a slow stretch, deep breathing with gentle arm movements or a few steps indoors. Exploration builds awareness and confidence without judgment.

Adapt. Tailor the activity to your current state: pain level, energy or mood. Adjust duration, position or pace as needed. Flexibility keeps you engaged and prevents the “all-or-nothing” trap.

Connect. Link motion with something pleasant: music, nature or companionship. Walk with a friend, stretch outdoors or move to your favourite song. These positive associations help your nervous system connect movement with safety and ease.

Progress. Gradually expand what feels possible; not to push harder, but to build trust in your body’s resilience. Every small gain strengthens confidence and reaffirms that movement can be safe.

Practical Ways to Build Confidence

Start small. Three to five minutes of gentle movement is enough to rebuild safety.
Use your baseline. Find what you can do without worsening symptoms over 24 hours, then build up gradually.
Notice patterns. Track what you did and how you felt; small insights show actual progress.
Expect normal soreness. Muscles reawakening may ache briefly. Temporary stiffness means activation, not injury.
Rest with purpose. Recovery is part of healing, not a setback.
Celebrate small wins. Every stretch before bed, short walk or moment of ease counts.

When Movement Feels Too Hard

Some days, pain or exhaustion makes any activity feel impossible. Those days don’t erase progress; brief pauses are part of adaptation, not failure.

If new, sharp or spreading pain appears, or if you lose strength or control, reach out to a healthcare professional.

For ordinary fluctuations, return to smaller movements once symptoms ease.

See Flare-Ups vs Daily Pain for pacing and recovery guidance.

If fear feels overwhelming, working with a physiotherapist or pain-informed therapist can help rebuild confidence safely. 

Learn here how fear can influence your progress and ways to break the fear-pain cycle.

Everyday Movement Counts

Movement doesn’t have to mean structured exercise; it can weave naturally into your day:

Stand and stretch once an hour.
Walk during calls.
Do gentle shoulder or ankle circles while seated.
Garden, cook or tidy with awareness.
Step outside for a few slow, grounding breaths.

These small actions keep your body engaged and restore a sense of ease in everyday life. Over time, ordinary moments of movement add up to meaningful progress.

Here you can find tools to help you regulate your nervous system.

FAQs

If I move, will I cause damage? 

Usually not. Persistent pain doesn’t mean ongoing injury. When pain lasts for months, nerves can stay “on guard” even after healing. Moving within your comfort range helps your body and brain relearn that activity is safe. Start small and stay curious; discomfort that settles soon after is a sign of adaptation, not harm.

Why does movement make me hurt more?

When the nervous system becomes sensitised, even gentle motion can feel amplified. That temporary increase in pain doesn’t mean damage; it’s your system testing for safety. Calm, repeated movement helps the brain update those signals so activity stops triggering alarm. If the soreness eases within a day or two, you’re on the right track.

How do I know what’s safe?

Pain is feedback, not failure. You should have a doctor check sharp, spreading, or unusual pain that persists. Familiar mild soreness that fades in 24-48 hours is safe. Try the “24-hour rule”: if you feel no major flare the next day, the activity fits your current capacity.

What if I can’t do what I used to? 

That’s normal and human. Healing with chronic pain often means redefining what progress looks like. Begin where you are now and build gradually. Each small, sustainable action strengthens trust between your body and brain and that trust matters more than intensity.

Will exercise make my pain worse? 

When done at the right pace, it usually helps more than it hurts. Overexertion can spike pain temporarily, but gentle, regular activity calms the nervous system and improves function. The goal isn’t to push limits, but to move often enough that your body feels safe again.

What kind of exercise is best? 

The one you enjoy and can repeat. Walking, swimming, stretching, yoga or light strength work all help; what counts most is consistency. Enjoyment keeps the brain’s reward pathways active, reducing fear and supporting long-term motivation.

Can I exercise during a flare-up? 

Yes, but dial it down. During flares, smaller, slower movements like stretching, gentle mobility or short walks can ease tension without overloading your system. Prolonged rest often increases stiffness and fatigue. Alternate movement with true rest rather than complete stillness.

Does movement help fatigue and brain fog? 

Yes. Low-intensity motion improves blood flow, oxygenation and hormone balance, all of which stabilise energy and focus. Even brief, rhythmic activity – a few minutes of walking or stretching – can lift fatigue and clear mental fog.

How much movement is enough? 

You don’t need hours, you need consistency. Five to ten minutes a day is enough to start retraining the pain system. Gradually extend time or variety as you feel ready. What matters most is frequency, not intensity.

What if I’m too afraid to start? 

Begin with breathing or small posture shifts. Every safe signal you send helps reshape how your nervous system interprets movement.

Progress is rarely linear, but every bit of motion you reclaim strengthens your capacity for the next one. Gradually, movement stops being about managing pain and becomes a way of returning to life. Be kind to yourself and stay curious.

Get Support in Your Inbox

Subscribe to the newsletter and let me help you turn confusion into clarity. The PDF I have prepared is a guide that will help you organise all the elements of your condition: symptoms, treatments and impact, so you can understand your pain behaviour. This is truly important when it comes to explaining it to healthcare professionals, loved ones and yourself.
“Clinical Clarity Workbook – A map for precise diagnosis“

Until next time,

Alina