• C A Paley and M I Johnson.
• *Airedale NHS Foundation Trust †Faculty of Health and Social Sciences, Leeds Beckett University ‡Leeds Pallium Research Group http://www.leeds.ac.uk/pallium.
• Clin J Pain. 2015 May 15.

IntroductionThe increasing prevalence of chronic pain and obesity has significant health and cost implications for economies in the developed and developing world. Evidence suggests that there is a positive correlation between obesity and chronic pain and the link between them is thought to be systemic inflammation.ObjectivesThe aim of this narrative review was to explore the physiological links between chronic musculoskeletal pain and obesity and to consider the potential role of regular physical activity in providing a means of managing obesity-related chronic pain.DiscussionSystemic inflammation, mechanical overload and autonomic dysfunction are associated with increased prevalence and severity of chronic pain in individuals with obesity. It has been proposed, therefore, that interventions which target systemic inflammation could help to reduce chronic pain in obese individuals. Reduction in abdominal fat has been shown to alleviate pain and reduce the systemic markers of inflammation that contribute to chronic pain. Interventions which include exercise prescription have been shown to reduce both abdominal fat and systemic inflammation. Furthermore, exercise is also known to reduce pain perception and improve mental health and quality of life which also improves pain outcomes. However, adherence to formal exercise prescription is poor and therefore exercise programmes should be tailored to the interests, needs and abilities of individuals in order to reduce attrition.

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