When muscle contracts against resistance, it releases myokines. These are signal molecules that fight inflammation, and your body makes them for free. Chronic pain makes you afraid to move. The muscle goes quiet, and that natural medicine stops just when you need it. Inflammation climbs, muscle wastes, and pain deepens. The right dose of movement reverses the spiral.
If you live with chronic pain and fear moving, this changes everything. Your muscles do more than move you. When you work them against resistance, they flood your blood with chemicals that fight inflammation. It is natural medicine your body makes for free. When you stop using them, that pharmacy goes dark and inflammation moves in. This article explains myokines. It shows why losing muscle costs so much in chronic pain. And it shows how the right dose of movement can reverse the spiral.
Where do myokines come from?
Early work by researchers such as Dr. Bente Pedersen showed that skeletal muscle is not just a motor. It is one of the largest endocrine organs (hormone-making organs) in your body. When muscle contracts, mostly against resistance, it sends signal molecules called myokines into your blood. These travel all over your body and have strong effects. Many of them calm inflammation and protect your metabolism. Worked muscle is literally making and releasing medicine.
What increases myokines?
There is a catch: this only happens when the muscle is used. Without steady use, the muscle goes quiet and the body’s soil runs dry. In patients who sit most of the day, the pharmacy is locked. One key myokine is interleukin-6 (IL-6). Earlier in this series, IL-6 from visceral fat (deep belly fat) was called inflammatory. That is true in that setting. But when working muscle releases IL-6 in a short burst, it sets off a chain that calms inflammation. It calls in other molecules that damp the fire. Same molecule, different setting.
How does losing muscle make chronic pain worse?
Now picture the chronic pain patient. Pain makes you afraid to move, so you sit still, often for years. Without resistance work, the muscle stops sending its protective myokines. You lose that signal exactly when you need it most. It snowballs. Muscle wastes, metabolism slows, insulin resistance worsens, inflammation climbs, and the pain deepens. It is a downward spiral, and losing muscle keeps it turning.
Should you exercise when you have chronic pain?
The science of muscle as an endocrine organ is now well established. Working muscle releases myokines that calm inflammation and help metabolism across the whole body. The protective role of exercise-made IL-6 is understood. And plenty of evidence shows the right exercise cuts chronic pain and body-wide inflammation. Still, if you are in real pain, being told to just exercise can feel dismissive. Pushing through agony is the wrong advice, and it can hurt you. What matters is appropriately dosed, intelligently progressed movement. Find the starting point your body can handle and build from there.
How the Padda Institute reopens the pharmacy
At the Padda Institute, we first use interventional and regenerative therapies to cut the pain enough to open a window. In that window, movement becomes possible again. Then we guide you into the right dose of resistance. As myokine signals come back online, body-wide inflammation falls and metabolism improves. The downward spiral turns into an upward one. Your muscles are a pharmacy that only opens when you use them. Our job is to make it safe for you to open it again.
Frequently asked questions
What are myokines?
Myokines are signal molecules your skeletal muscle sends into the blood when it contracts, mostly against resistance. Many of them calm inflammation and protect metabolism. That is one of the deep reasons movement protects you 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 advice, and it can hurt you. The goal is the right dose of movement, stepped up wisely. It starts at a point your body can handle 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.
Are myokines good or bad?
Many myokines are protective. They fight inflammation and support metabolism. Interleukin-6 (IL-6) shows why the setting matters. From visceral fat, IL-6 is inflammatory. But in short bursts from working muscle, it sets off a chain that calms inflammation. Same molecule, different source, different effect. Working muscle is the source you want.
What is myokine deficiency?
Myokine deficiency is what happens when muscle stops getting worked. Without regular work against resistance, the muscle goes quiet. It stops releasing its protective myokines. In people who have sat still for a long time, that natural pharmacy is locked. Inflammation climbs, metabolism slows, insulin resistance worsens and muscle wastes. That deepens the pain and keeps the spiral turning.
Why does chronic pain lead to muscle loss?
Pain makes you afraid to move, so you move less, often for years. Muscle that is not worked against resistance wastes away. It stops sending its signals that calm inflammation. That makes inflammation and pain worse, and moving gets even harder. At the Padda Institute, we first cut the pain enough to open a window for movement. Then we guide you into the right dose of resistance so myokine signals come back online.
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
- Working muscle releases myokines that fight inflammation, including exercise-made IL-6.
- This mechanism is well established. So is the evidence that the right exercise cuts chronic pain.
- Sitting still shuts the myokine pharmacy exactly when you need it. That feeds a downward spiral.
- Next step: a plan that reduces pain first, then reintroduces safely dosed movement at the Padda Institute.
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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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.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
