Regular exercise safely eases chronic pain in hemophilia: Study
Carefully designed, guided activity improves health
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Regular and sustained physical exercise — including aerobic activities, strength training, and balance exercises — may help ease chronic pain, improve physical performance, and enhance quality of life in people with hemophilia of all ages, according to a review study.
The researchers found that exercise is generally safe when programs are carefully designed and properly supervised. They highlighted the importance of individualized approaches and multidisciplinary care to maximize benefits and minimize risks.
“Significant benefits can be achieved when [physical exercise] interventions are implemented and adhered to in adults with hemophilia, effectively supporting chronic pain management,” the researchers wrote. “This study provides a scientific basis for designing individualized exercise programs, highlighting the importance of multimodal approaches and collaborative, tailored interventions.”
The study, “Optimizing Physical Exercise for Chronic Pain Relief in Hemophilia Patients,” was published in the journal Pain Management Nursing.
Relieving joint pain is key in hemophilia care
Hemophilia refers to a group of disorders characterized by easy or prolonged bleeding, especially in the joints and muscles. Over time, this can lead to joint damage, reduced mobility, and chronic joint or muscle pain, significantly affecting physical function, mental health, and overall quality of life.
“Consequently, effective pain management, prevention of joint damage, and improvement of quality of life have become central goals in both clinical and nursing practice for individuals with hemophilia,” the researchers wrote.
Regular physical exercise is widely recognized as beneficial for people with hemophilia. Evidence suggests that, when appropriately prescribed and supervised, it can strengthen muscles, improve joint stability, and ease pain, while also supporting mobility and psychological well-being.
Still, it’s a challenge for many patients, particularly adults. Safety concerns, especially those involving the risk of triggering bleeding episodes or worsening joint damage, have made patients and their families cautious. There’s also a lack of long-term studies in adults about how long the benefits last, and current guidelines often provide only broad recommendations with limited practical guidance.
“These challenges not only restrict the dissemination of exercise interventions but also underscore the persistent ‘evidence gap’ between research and clinical practice,” the researchers wrote.
The team, in China, conducted a review of published studies to evaluate the effectiveness and safety of physical exercise for managing chronic pain in adults with hemophilia.
Of 2,462 studies initially identified, 16 were included in the final analysis. These comprised one clinical decision document, two clinical guidelines, nine systematic reviews, and four expert consensus statements, published from 2016 to 2023.
Across the included studies, the researchers identified 33 key evidence-based findings covering the benefits of exercise, safety considerations, modality selection, frequency and intensity, and interdisciplinary care.
The findings showed that physical exercise can significantly reduce chronic pain, improve joint function, and enhance quality of life. These benefits are largely linked to stronger muscles and improved joint stability, which can help break the cycle of recurrent joint bleeding and damage that leads to chronic pain.
Exercise was also found to be generally safe. This was particularly true when exercise programs were carefully designed to take into account factors such as joint function and physical condition, performed under proper supervision, alongside preventive treatments to reduce bleeding risk, and gradually progressed over time.
Studies point to specific benefits
Different types of exercise offered different benefits. Aerobic activities, such as walking, cycling, and swimming, were associated with improved mobility, fitness, and pain relief. Strength training was especially effective at improving muscle strength and joint stability, and some studies suggested it may also help reduce bleeding episodes.
Other approaches, including balance and combined exercise programs, were linked to improvements in coordination and flexibility, although the supporting evidence in this area was of low quality. Water-based exercise showed mixed results, with some studies raising potential safety concerns.
Most exercise programs lasted four to 12 weeks. Participants exercised two to three times per week, and reported consistent reductions in pain and improvements in physical function. Studies indicated positive effects across all age groups but also highlighted the need for individualized exercise plans.
Younger patients benefited from shorter, more structured sessions, typically lasting about 30 minutes. In contrast, older adults required lower-intensity programs with longer session durations, lighter loads, and more frequent rest to minimize fatigue, as well as longer stretching periods to reduce the risk of muscle injury.
Although evidence from longer-term follow-up studies was limited, a few studies suggested additional benefits, such as reduced bleeding episodes, with sustained exercise.
The researchers emphasized the importance of a multidisciplinary approach, involving healthcare professionals such as hematologists, physiotherapists, nurses, and psychologists, to ensure safe and effective implementation. Regular monitoring and personalized adjustments to exercise programs were highlighted as key to maximizing benefits and minimizing risks.
“The information in this study indicates that exercise interventions can safely and effectively relieve pain and improve function in adults with hemophilia,” the researchers wrote. “Incorporating exercise into standardized management is recommended, with strengthened long-term follow-up and research on psychological outcomes.”
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