Best Exercises for Acute Pain

When you have acute pain, it may seem like the last thing you should do is exercise. But depending on the pain, certain movements can be a great idea, provided you get the green light from your doctor.

“Movement is highly beneficial for most individuals experiencing acute pain, because it helps to prevent the deconditioning and muscle stiffness that can result from inactivity, ultimately speeding up recovery,” says Alexander Shustorovich, DO, a physiatrist at the Center for Sports and Spine Medicine at Hackensack Meridian JFK Johnson Rehabilitation Institute in New Jersey.

But because each case of acute pain is different, you’ll need to see a doctor before embarking on any exercise. That could be your primary care provider, a provider at an urgent care clinic, or a pain management specialist or physiatrist — a doctor who specializes in treating pain without surgery. “Any exercise program for acute pain must be initiated and modified under the direct guidance of your physician,” says Dr. Shustorovich. “The foundational step is an accurate diagnosis, as the appropriate movement for a muscle strain could be detrimental for a stress fracture or a disk issue.”

While gentle movement is beneficial for many types of acute pain, there are exceptions where rest is essential to prevent further injury and allow for proper healing. “Individuals with suspected or confirmed serious injuries, such as bone fractures, severe sprains, or a torn Achilles tendon, should immobilize the affected area and seek immediate medical attention,” says Shustorovich.

Other red flags that should prompt you to hold off on movement and seek immediate medical attention include:

• Symptoms of swelling within a muscle (acute compartment syndrome):

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• Extreme and intense pain in the muscle that worsens with use
• Tingling or burning sensation in the skin
• Numbness
• Muscle tightness or feeling of fullness

• Back pain accompanied by:
• Loss of bladder or bowel control
• Fever
• Significant weakness

“In all these instances, and especially after surgery, it is critical to consult with a healthcare professional to determine when it is safe to gradually reintroduce movement and to receive a personalized treatment plan,” says Shustorovich.

There are many reasons to get moving if you have acute pain. These include:

• Reduced Pain Signals Slow, controlled movements paired with deep breathing activate the parasympathetic nervous system, which lowers muscle tension and turns down pain signals. This is due to something called the “gate control theory.” Shustorovich says, “Essentially, by engaging in gentle activity, you create nonpainful sensory inputs like pressure and motion that travel to the spinal cord and ‘close the gate’ on pain signals, preventing them from reaching the brain.”
• Better Circulation Gentle, continuous movement boosts blood flow to sore or injured areas and reduces swelling. “This enhanced circulation is crucial, as it delivers the oxygen and nutrients necessary for tissue repair while helping to flush out inflammatory substances that contribute to pain,” says Shustorovich.
• Improved Pain-Stiffness Cycle Acute pain and stiffness can create a vicious cycle. Acute pain often leads to guarding and inactivity, which causes muscles and joints to become stiff, leading to more pain and a further reluctance to move. “By introducing gentle, controlled motion, we can alleviate stiffness, reduce muscle tension, and restore function, thereby accelerating recovery and preventing the transition to a chronic pain state,” says Shustorovich.
• More Confidence and Less Fear Studies show avoiding movement due to pain can increase fear and sensitivity, called avoidance behavior.

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   Safe, gradual movement reassures the nervous system that activity is not dangerous, which can lower pain over time.

The ideal exercises for acute pain are the ones that calm your nervous system and help ease pain and inflammation to restore movement and function. Here are a few examples to discuss with your doctor:

Gentle Walking

Benefits “Walking is excellent for most types of acute pain, especially low back pain,” says Shustorovich. “It helps improve general mobility, reduces stiffness, and can alleviate pain from muscle spasms.”

Precautions “Start with short, slow walks on a flat, smooth surface to avoid jarring the joints,” says Shustorovich. If you have been inactive, begin with 10 to 15 minutes of walking and gradually increase the duration. “Pay attention to your posture, and stop if you experience sharp or increasing pain,” he adds.

Water-Based Exercise (Aquatic Therapy)

Benefits “It’s ideal for individuals with joint pain like arthritis, significant back pain, or those for whom weight-bearing exercise is too painful,” says Shustorovich.

Precautions “It’s best to start in a shallow pool where you can stand comfortably,” says Shustorovich. “Begin with simple movements like walking forward and backward before progressing to other gentle exercises.” Avoid any movements that cause sharp pain, and if you’ve had surgery recently, make sure the incision is fully healed before entering a pool.

Cat-Cow Stretch

Benefits “This stretch is particularly effective for relieving stiffness and tension in the lower and mid back,” says Shustorovich.

Precautions “Move slowly and in coordination with your breath. Avoid pushing into any position that causes sharp or radiating pain,” says Shustorovich. The goal is gentle, fluid motion, not an extreme stretch.

Before starting any exercise program, get the go-ahead from the healthcare provider who diagnosed you with acute pain. “Your doctor will create a highly personalized and targeted movement plan that considers the specific nature of your injury, your overall health, and your current limitations, ensuring the exercises are therapeutic, rather than harmful,” says Shustorovich.

As you continue to heal, it’s also key to consult your doctor before introducing new exercises into your routine. “Attempting to increase the intensity, duration, or type of exercise on your own can easily lead to reinjury or a significant setback,” says Shustorovich. “By working collaboratively, we can safely and methodically progress your routine, ensuring that each change facilitates healing, restores function, and ultimately prevents your acute pain from becoming a chronic problem.”

• For the first 24 to 72 hours after acute pain starts, you should avoid exercise and focus on rest, ice, compression, and elevation.
• Get a proper diagnosis before starting any exercises, as what can help one type of injury may make another one worse.
• Gentle exercises that can help in many cases of acute pain include walking, aquatic therapy, and stretches such as Cat-Cow pose.