Has anyone ever scolded your PoC: “you need to calm the pain down before you can expect a patient to exercise!” This just never made sense to me, as even before PT school I would run to help a stiff neck, or lift to cure a sore knee. This article fits my biases #wisethoughts

This article tried to find dose response of exercise on chronic pain using FITT priniciples.
Comparing exercise effect on pain by condition: only neck pain had a significant correlation with duration
Comparing effect on pain by exercise type: no relations found

After their initial analyses didn’t turn up much, they got creative with multi-variate analysis: time x duration and frequency x duration came back significant. And after this finding, they went back to the univariate analyses and reran with intensity x time - nothing came back

So basically: no real dose effect of exercise on chronic pain found, however, We have evidence that supports exercise in significantly reducing chronic pain. To me, this means that exercise is effective but not efficacious for chronic pain

I DON’T LIKE THIS. I want my skilled and well informed exercise prescription to matter. MD’s don’t just hand out pills and say “take however many you feel like.” But when it comes to chronic pain, exercise specificity probably doesn’t matter.

It likely matters if your goal is to improve strength or performance. That means we just need to ask our patients: “what do you want out of PT?” If all they want is to reduce pain, give them a HEP that is accessible and don’t make it complicated.