REVIEW PAPER
Effect of therapeutic exercise on chronic pain in elderly: a narrative review
 
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1
School of Physical Therapy and Occupational Therapy, Faculty of Health Sciences, Universidad Católica Silva Henríquez, Santiago, Chile
 
2
Faculty of Health Sciences, Universidad Arturo Prat, Victoria, Chile
 
 
Submission date: 2025-08-12
 
 
Acceptance date: 2026-01-29
 
 
Online publication date: 2026-07-16
 
 
Corresponding author
Jorge Ugarte Llantén   

Universidad Católica Silva Henríquez, Lo Cañas 3636, Santiago, Chile
 
 
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Chronic pain is a highly prevalent condition in older adults and is commonly associated with comorbidities. Interventions such as therapeutic exercise represent the cornerstone of chronic pain management in this population. This review evaluated the effects of therapeutic exercise on older adults with chronic pain.

Methods:
This narrative review was conducted using the PubMed and Web of Science databases. A combination of search terms was employed, including "Older adults", "Aged", "Chronic pain", "Persistent pain", "Exercise therapy", "Therapeutic exercise", and "Rehabilitation exercises". The inclusion criteria comprised controlled clinical trials published in English within the last five years in which therapeutic exercise was the primary intervention for chronic pain in older adults.

Results:
The initial search yielded 33 studies, of which 10 studies were ultimately selected based on the inclusion criteria for analysis in this narrative review. The interventions and evaluations confirm that therapeutic exercise is beneficial for modulating chronic pain in older adults.

Conclusions:
This review concludes that therapeutic exercise in all its forms can positively modulate chronic pain in older adults.
REFERENCES (29)
1.
Treede R-D, Rief W, Barke A, Aziz Q, Bennett MI, Be­no­liel R, Cohen M, Evers S, Finnerup NB, First MB, Giam­berardino MA, Kaasa S, Korwisi B, Kosek E, Lavand’­homme P, Nicholas M, Perrot S, Scholz J, Schug S, Smith BH, Svensson P, Vlaeyen JWS, Wang S-J. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain. 2019;160(1):19–27; doi: 10.1097/j.pain.0000000000001384.
 
2.
Dagnino APA, Campos MM. Chronic pain in the elderly: mechanisms and perspectives. Front Hum Neurosci. 2022;16:736688; doi: 10.3389/fnhum.2022.736688.
 
3.
Da Silva JT, Tricou C, Zhang Y, Tofighbakhsh A, Semi­no­wicz DA, Ro JY. Pain modulatory network is influenced by sex and age in a healthy state and during osteoarthritis progression in rats. Aging Cell. 2021;20(2):e13292; doi: 10.1111/acel.13292.
 
4.
Tavares DRB, Moça Trevisani VF, Frazao Okazaki JE, Valéria De Andrade Santana M, Pereira Nunes Pinto AC, Tutiya KK, Gazoni FM, Pinto CB, Cristina Dos Santos F, Fregni F. Risk factors of pain, physical function, and health-related quality of life in elderly people with knee osteoarthritis: a cross-sectional study. Heliyon. 2020;6(12):e05723; doi: 10.1016/j.heliyon.2020.e05723.
 
5.
Domenichiello AF, Ramsden CE. The silent epidemic of chronic pain in older adults. Prog Neuropsychopharmacol Biol Psychiatry. 2019;93:284–90; doi: 10.1016/j.pnpbp.2019.04.006.
 
6.
Bonardi JMT, Lima LG, Campos GO, Bertani RF, Moriguti JC, Ferriolli E, Lima NKC. Effect of different types of exercise on sleep quality of elderly subjects. Sleep Med. 2016;25:122–9; doi: 10.1016/j.sleep.2016.06.025.
 
7.
García-Domínguez M. Chronic pain in the elderly: exploring cellular and molecular mechanisms and therapeutic perspectives. Front Aging. 2024;5:1477017; doi: 10.3389/fragi.2024.1477017.
 
8.
Lee H, Yong SY, Choi H, Yoon GY, Koh S. Association between loneliness and cognitive function, and brain volume in community-dwelling elderly. Front Aging Neurosci. 2024;16:1389476; doi: 10.3389/fnagi.2024.1389476.
 
9.
Rufa A, Beissner K, Dolphin M. The use of pain neuroscience education in older adults with chronic back and/or lower extremity pain. Physiother Theory Pract. 2019;35(7):603–13; doi: 10.1080/09593985.2018.1456586.
 
10.
Leung DKY, Fong APC, Wong FHC, Liu T, Wong GHY, Lum TYS. Nonpharmacological interventions for chronic pain in older adults: a systematic review and meta-analysis. Gerontologist. 2024;64(6):gnae010; doi: 10.1093/geront/gnae010.
 
11.
Vincent KR, Braith RW, Feldman RA, Magyari PM, Cutler RB, Persin SA, Lennon SL, Md AHG, Lowenthal DT. Resistance exercise and physical performance in adults aged 60 to 83. J Am Geriatr Soc. 2002;50(6):1100–7; doi: 10.1046/j.1532-5415.2002.50267.x.
 
12.
Sukhera J. Narrative reviews: flexible, rigorous, and practical. J Grad Med Educ. 2022;14(4):414–7; doi: 10.4300/JGME-D-22-00480.1.
 
13.
Baethge C, Goldbeck-Wood S, Mertens S. SANRA – a scale for the quality assessment of narrative review articles. Res Integr Peer Rev. 2019;4:5; doi: 10.1186/s41073-019-0064-8.
 
14.
Otones P, García E, Sanz T, Pedraz A. A physical activity program versus usual care in the management of quality of life for pre-frail older adults with chronic pain: randomized controlled trial. BMC Geriatr. 2020;20:396; doi: 10.1186/s12877-020-01805-3.
 
15.
Shin H-J, Kim S-H, Hahm S-C, Cho H-Y. Thermotherapy plus neck stabilization exercise for chronic nonspecific neck pain in elderly: a single-blinded randomized controlled trial. Int J Environ Res Public Health. 2020;17(15):5572; doi: 10.3390/ijerph17155572.
 
16.
Vaillancourt S, Coulombe-Lévêque A, Fradette J, Martel S, Naour W, da Silva RA, Léonard G. Combining transcutaneous electrical nerve stimulation with therapeutic exercise to reduce pain in an elderly population: a pilot study. Disabil Rehabil. 2021;43(15):2141–8; doi: 10.1080/09638288.2019.1693639.
 
17.
Cheng S-T, Chen PP, Chow YF, Law ACB, Lee JSW, Leung EMF, Sim TC, Tam CWC, Cheng JOS. An exercise cum cognitive-behavioral intervention for older adults with chronic pain: a cluster-randomized controlled trial. J Consult Clin Psychol. 2022;90(3):221–33; doi: 10.1037/ccp0000698.
 
18.
Minakawa Y, Miyazaki S, Waki H, Yoshida N, Iimura K, Itoh K. Trigger point acupuncture and exercise for chronic low back pain in older adult: a preliminary randomized clinical trial. J Acupunct Meridian Stud. 2022;15(2):143–51; doi: 10.51507/j.jams.2022.15.2.143.
 
19.
Lytras D, Iakovidis P, Sykaras E, Kottaras A, Kasimis K, Myrogiannis I, Barouxakis A, Tarfali G. Effects of a tailored mat-Pilates exercise program for older adults on pain, functioning, and balance in women with chronic non-specific low back pain: a randomized controlled trial. Aging Clin Exp Res. 2023;35:3059–71; doi: 10.1007/s40520-023-02604-7.
 
20.
Tse MMY, Yan E, Tang ASK, Cheung D, Ng S. A music-with-movement exercise programme for community-dwelling older adults suffering from chronic pain: a pilot randomized controlled trial. Nursing Open. 2023;10(9):6566–74; doi: 10.1002/nop2.1915.
 
21.
Hicks GE, George SZ, Pugliese JM, Coyle PC, Sions JM, Piva S, Simon CB, Kakyomya J, Patterson CG. Hip-focused physical therapy versus spine-focused physical therapy for older adults with chronic low back pain at risk for mobility decline (MASH): a multicentre, single-masked, randomised controlled trial. Lancet Rheumatol. 2024;6(1):e10–20; doi: 10.1016/S2665-9913(23)00267-9.
 
22.
Larsen JB, Skou ST, Laursen M, Bruun NH, Arendt-Nielsen L, Madeleine P. Exercise and pain neuroscience education for patients with chronic pain after total knee arthroplasty: a randomized clinical trial. JAMA Netw Open. 2024;7(5):e2412179; doi: 10.1001/jamanetwork­open.2024.12179.
 
23.
de Jesus Silva HD, Miranda JPD, Silva WT, Fonseca LS, Xavier DM, Oliveira MX, Oliveira VC. Group-based exercise reduces pain and disability and improves other outcomes in older people with chronic non-specific low back pain: the ESCAPE randomised trial. J Physiother. 2025;71(2):108–16; doi: 10.1016/j.jphys.2025.03.003.
 
24.
Skou ST, Roos EM, Laursen MB, Rathleff MS, Arendt-Nielsen L, Simonsen O, Rasmussen S. A randomized, controlled trial of total knee replacement. N Engl J Med. 2015;373(17):1597–606; doi: 10.1056/NEJMoa1505467.
 
25.
Cruz-Díaz D, Bergamin M, Gobbo S, Martínez-Amat A, Hita-Contreras F. Comparative effects of 12 weeks of equipment based and mat Pilates in patients with chronic low back pain on pain, function and transversus abdominis activation. A randomized controlled trial. Complement Ther Med. 2017;33:72–7; doi: 10.1016/j.ctim.2017.06.004.
 
26.
Itoh K, Katsumi Y, Hirota S, Kitakoji H. Effects of trigger point acupuncture on chronic low back pain in elderly patients – a sham-controlled randomised trial. Acupunct Med. 2006;24(1):5–12; doi: 10.1136/aim.24.1.5.
 
27.
Wang Y, Li S, Zhang Y, Chen Y, Yan F, Han L, Ma Y. Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: a systematic review and meta-analysis of 32 randomized controlled trials. Phys Ther Sport. 2021;48:177–87; doi: 10.1016/j.ptsp.2021.01.004.
 
28.
Itoh K, Katsumi Y, Kitakoji H. Trigger point acupuncture treatment of chronic low back pain in elderly patients – a blinded RCT. Acupunct Med. 2004;22 (4):170–7; doi: 10.1136/aim.22.4.170.
 
29.
Palmer KL, Shivgulam ME, Champod AS, Wilson BC, O’Brien MW, Bray NW. Exercise training augments brain function and reduces pain perception in adults with chronic pain: a systematic review of intervention studies. Neurobiol Pain. 2023;13:100129; doi: 10.1016/j.ynpai.2023.100129.
 
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