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MSK Pain – Improves mental health

Improves mental health

Evidence summary

Whilst physical activity interventions have been shown to improve a number of patient outcomes, there is conflicting evidence regarding depression and psychological function. One RCT included within a Cochrane review demonstrated a large effect in favour of resistance exercises on depression in those with fibromyalgia, but the same review demonstrated no effect on overall mental health [1]. An earlier Cochrane review concluded that psychological function cannot be expected to improve with aerobic exercises in those with fibromyalgia [2].

Quality of evidence

Low quality

Strength of recommendation

Strong – while the evidence supporting an improvement in mental health outcomes is poor, expert clinical consensus is that people should be informed of the positive effect of physical activity on their mental health.


Regular physical activity is known to be an effective intervention in those with depression, but the quality of evidence in the chronic pain population is poor. Expert consensus is that the reduced pain and improved function that can be expected from regular physical activity is likely to improve an individual’s mental wellbeing.  Consider referring those presenting with a significant psychosocial contribution to exercise intervention programmes with a psychological component, ideally group programmes.


1         Busch AJ, Webber SC, Richards RS, et al.Resistance exercise training for fibromyalgia. Cochrane Database Syst RevPublished Online First: 2013. doi:10.1002/14651858.CD010884

2         Busch AJ, Barber KAR, Overend TJ, et al.Exercise for treating fibromyalgia syndrome (Review). Cochrane Database Syst RevPublished Online First: 2007. doi:10.1002/14651858.CD003786.pub2.Copyright