Chronic pain management in the obese patient: a focused review of key challenges and potential exercise solutions
Open accessAbstract
In obese persons, general and specific musculoskeletal pain is common. Emerging evidence suggests that obesity modulates pain via several mechanisms such as mechanical loading, inflammation, and psychological status. Pain in obesity contributes to deterioration of physical ability, health-related quality of life, and functional dependence. We present the accumulating evidence showing the interrelationships of mechanical stress, inflammation, and psychological characteristics on pain. While acute exercise may transiently exacerbate pain symptoms, regular participation in exercise can lower pain severity or prevalence. Aerobic exercise, resistance exercise, or multimodal exercise programs (combination of the two types) can reduce joint pain in young and older obese adults in the range of 14%-71.4% depending on the study design and intervention used. While published attrition rates with regular exercise are high (∼50%), adherence to exercise may be enhanced with modification to exercise including the accumulation of several exercise bouts rather than one long session, reducing joint range of motion, and replacing impact with nonimpact activity. This field would benefit from rigorous comparative efficacy studies of exercise intensity, frequency, and mode on specific and general musculoskeletal pain in young and older obese persons.
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The risk of musculoskeletal injury from traditional exercise is particularly high in obese individuals, as excess body weight can lead to significant stress and pain in the joints of the lower limbs, thereby discouraging physical activity.
“This risk is particularly high in obese individuals, as their excess body weight can lead to significant stress and pain in the joints of the lower limbs, thereby discouraging physical activity (Pippi et al., 2022; Zdziarski, Wasser & Vincent, 2015).”
From Effect of water-based aerobic training on anthropometric, biochemical, cardiovascular, and explosive strength parameters in young overweight and obese women: a randomized controlled trial (2025) · cites this paper as Zdziarski, Wasser & Vincent, 2015
The Introduction and “Effects of pain on physical activity in obesity” state that excess weight stresses joints, including those in the lower limbs, and that musculoskeletal pain hinders exercise participation. The cited passages do not establish that traditional exercise poses a particularly high risk of musculoskeletal injury in obese individuals. (LLM, conf=0.85)
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- Authors
- Vincent, H., Zdziarski, L., & Wasser, J.
- Affiliations
- University of Florida (US)
- Corresponding author
- Vincent, Heather
- Venue
- Journal of Pain Research
- Publisher
- Informa UK Limited
- Published
- 2015-02
- Volume
- 8
- Pages
- 63
- ISSN
- 1178-7090 (ISSN-L)
- PMC
- PMC4332294
- OpenAlex
- W2084349608
- Cited by
- 121
- References
- 120
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 13 · 2023: 8 · 2022: 12 · 2021: 14 · 2020: 12 · 2019: 10 · 2018: 21 · 2017: 7 · 2016: 9 · 2015: 3
- FWCI
- 1.68
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Pain Research (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Keywords
- obesity, chronic pain, musculoskeletal pain, exercise intervention, aerobic exercise, resistance training, multimodal training, joint pain, mechanical loading, inflammation, psychological factors, exercise adherence, attrition, health-related quality of life, older adults
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