If you live with chronic pain and have become afraid to move, this changes everything. Your muscles are not just for movement. When you contract them against resistance, they release a wave of anti-inflammatory chemicals into your bloodstream, natural medicine your body makes for free. When you stop using them, that pharmacy goes dark and inflammation moves in. This article explains myokines, why losing muscle is so costly in chronic pain, and how appropriately dosed movement can reverse the spiral.
Your muscle is an endocrine organ
Pioneering work by researchers such as Dr. Bente Pedersen revealed that skeletal muscle is not just a motor, it is one of the largest endocrine organs in your body. When muscle contracts, especially against resistance, it secretes signaling molecules called myokines into your bloodstream. These travel throughout your body and exert powerful effects, and many of them are anti-inflammatory and metabolically protective. Worked muscle is literally manufacturing and releasing medicine.
The pharmacy only opens when the muscle is used
There is a catch: this only happens when the muscle is used. Without consistent stimulus, the muscle falls silent and the biological soil becomes depleted. In sedentary patients, the pharmacy is effectively locked. One key myokine is interleukin-6 (IL-6). Earlier in this series, IL-6 released from visceral fat was described as inflammatory, and that is true in that context. But when IL-6 is released acutely from contracting muscle, it triggers an anti-inflammatory cascade, prompting other molecules that dampen inflammation. Same molecule, different context.
How chronic pain creates a downward spiral
Now picture the chronic pain patient. Pain makes you afraid to move, so you become sedentary, often for years. Without resistance stimulus, the muscle stops secreting its protective myokines, and you lose that signaling exactly when you need it most. It compounds: muscle wastes, metabolism slows, insulin resistance worsens, inflammation climbs, and the pain deepens. It is a downward spiral, and losing muscle is what keeps it turning.
Movement is medicine, but the instruction 'just exercise' is not enough
The science of muscle as an endocrine organ is now well established. Contracting muscle releases myokines with systemic anti-inflammatory and metabolic benefits, the protective role of exercise-induced IL-6 is understood, and there is extensive evidence that appropriate exercise reduces chronic pain and systemic inflammation. That said, if you are in real pain, being told to just exercise can feel dismissive, and pushing through agony is the wrong instruction that can hurt you. What matters is appropriately dosed, intelligently progressed movement, finding the entry point your body can tolerate and building from there.
How the Padda Institute reopens the pharmacy
At the Padda Institute, we first use interventional and regenerative therapies to reduce the pain enough to create a window, an opening where movement becomes possible again. Then we guide you into appropriately dosed resistance. As that myokine signaling comes back online, systemic inflammation falls, metabolism improves, and the downward spiral reverses into an upward one. Your muscles are a pharmacy that only opens when you use them, and our job is to make it safe for you to open it again.
Frequently asked questions
What are myokines?
Myokines are signaling molecules that your skeletal muscle secretes into the bloodstream when it contracts, especially against resistance. Many of them are anti-inflammatory and metabolically protective, which is one of the deep reasons movement is protective in chronic pain.
If I am in severe pain, does 'exercise is medicine' mean I should push through it?
No. Pushing through agony is the wrong instruction and can hurt you. The goal is appropriately dosed, intelligently progressed movement that starts at an entry point your body can tolerate and builds from there. Individual results vary.
Should I start an exercise or supplement program on my own while on pain medication?
Talk to your physician first so movement is dosed safely for your condition. Do not start, stop, or change any medication without consulting your physician.
Where are you located and how do I book?
Padda Institute Center for Interventional Pain Management, 4477 Woodson Rd, Suite 100, St. Louis, MO 63134. Book at painmd.tv/appointment/ or call (314) 481-5000.
Key takeaways
- Contracting muscle releases anti-inflammatory myokines, including exercise-induced IL-6.
- This mechanism is well established, as is evidence that appropriate exercise reduces chronic pain.
- Inactivity silences the myokine pharmacy exactly when you need it, feeding a downward spiral.
- Next step: a plan that reduces pain first, then reintroduces safely dosed movement at the Padda Institute.
Medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP — Board Certified in Anesthesiology, Pain Medicine, Interventional Pain Management, Addiction Medicine, and Obesity Medicine. Last reviewed July 2026.
This article is educational and is not a substitute for evaluation, diagnosis, or treatment by a physician. Individual results vary. Do not start, stop, or change any medication without consulting your physician.
Find the source of your pain — not just the signal
Padda Institute Center for Interventional Pain Management builds a customized, root-cause plan for each patient. Interventional care and metabolic medicine, under one roof in St. Louis.
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Dr. Gurpreet Singh Padda, MD, MBA, MHP
