Commencing a physical activity program

Incorporate physical activity programs into the person’s chronic pain management plan. Short- and long-term goals can be set collaboratively between clinician and patient; family or carer involvement is also beneficial.

Consider the person’s physical activity preferences when creating a physical activity plan because this will optimise engagement and improve long-term adherence. Prioritise self-care and dignity (eg activities of toileting and showering), followed by activities that promote mobility and daily living within the home (eg being able to move throughout the house without aids, preparing meals, completing homework). Activities outside of the home should then be considered (eg attending school or work, participating in leisure activities or organised sport).

No form of physical activity is superior to another and a combination of activities, such as partial weight-bearing (eg pool-based activity, cycling) and full weight-bearing (eg walking, weights), should be used. A person is more likely to adhere to the plan if less equipment is required. For examples of specific age-appropriate exercises, see the Department of Health website.

Some physiotherapists have specialised skills in assessing people with complex pain conditions and other medical comorbidities. Individualised exercises prescribed and monitored by a physiotherapist may have an additional role for some people with chronic pain. The aim of any physical activity plan is to support the person to self-manage physical activity within approximately 3 months.

Pool-based exercise (known as aquatic physiotherapy) involves goal-oriented individualised exercise programs that most people can continue independently after a few sessions. Pool-based exercise is only a partial weight-bearing activity and should be combined with full weight-bearing activities. Immersion in thermoneutral (34°C) water provides people with a sense of wellbeing and relaxation, improves function and reduces pain.