Exercise and movement in musculoskeletal pain: a double-edged problem

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Purpose of reviewExercise and movement are increasingly used in pain management and in palliative care, outside the traditional context of physical medicine and rehabilitation. This critical review aims to provide specialists in pain and palliative medicine with recent insights into the use of exercise and movement in the approach to musculoskeletal disorders when pain and disability are the major complaints.Recent findingsIf there is a common sense linking pain and movement in both directions, that is pain influencing movement – as a withdrawal movement or a reduction of mobility as a defense reaction – or movement evoking pain, not so clear and recognized is the link between exercise and movement in controlling pain.SummaryConflicting results emerge between absolutely convincing basic science research confirming important effects induced by movement and exercise on pain and substantial poor low evidence level from clinical research as stated by almost all systematic reviews. The need of rigorous clinical trials is mandatory to ascertain a real clinical benefit for the use of movement and exercise for pain control.

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