Exercise after surgery may ease lasting pain. The proof is thin.

People say: “Exercise after surgery prevents lasting pain” We read the study.

What they did

Meta-analysis of randomised trials. 1,155 people. 13 trials published 2000-2025; pain followed 3 to 12 months after surgery.

Many trials, added up. In each one, chance decided who did what.

Who: Adult surgery patients (aged ~38-69, 67.8% female) after spine surgery (6 trials), knee or hip replacement (3 + 1), mastectomy for breast cancer (2) or lung resection (1); trials from Australia, Brazil, Canada, Denmark, Iran, New Zealand, Norway, Spain, Thailand and Turkey

What they found
  • Pain drop you'd feel2 of 13trials
  • Still better at 1 year1 of 6trials checked
  • Other group did better3 of 13trials
The catch

More to know, from our read of the paper:

  • GRADE certainty LOW (downgraded for risk of bias and inconsistency). Authors: evidence 'insufficient to establish the definitive efficacy'; 'inconclusive'
  • Only 3 of 13 trials were low risk of bias; 7 high risk, 3 some concerns. Trials were small (median 67 patients, range 20-194)
  • Any benefit was time- and measure-dependent and of 'modest clinical relevance'; most group differences were gone by 12 months
  • Pain was self-reported in every trial, patients could not be blinded, and most control groups were passive (usual care), so attention/expectation effects can't be ruled out
  • The review does not tell anyone to skip post-surgery rehab; it only says exercise programmes have not been proven to prevent lasting pain
The verdict

Might help early. Not proven to last.

In short

This systematic review gathered 13 randomized trials with 1,155 patients after spine, knee, hip, breast or lung surgery. It asked whether exercise programs prevent or reduce pain that lasts 3 months or more after surgery. Only 2 trials found a pain drop big enough for patients to feel, and by 12 months only 1 of 6 trials still saw a benefit; in 3 trials the comparison group did better. The authors rate the evidence as low quality and call it inconclusive.

The video
The paper

Muñoz-Vergara D, Wilson JM, Cronin AE, Park SJ, Ma Y, Burton WM, Yang E, Dubinsky E, Wayne PM, Schreiber KL (2026). A systematic review of physical activity-based interventions to prevent or reduce chronic post-surgical pain. Pain Medicine.

Design: Meta-analysis of randomised trials · systematic review of 13 randomized controlled trials with a narrative synthesis (SWiM) and GRADE rating; no meta-analysis (too heterogeneous); PROSPERO CRD42025626850

DOI: 10.1093/pm/pnag050

Goals:

Get fitter
How we checked

We read the abstract and the full text of this paper and checked every number on this page against it (17 facts, checked on 2026-10-29). The study design is named above. Cohort and other observational studies are described as linked, not proven. Found an error? Email theis@onestudyaday.com.

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