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Exercise Prehabilitation Shows No Significant Pain ReductionExercise before breast cancer surgery may help manage post-surgery pain

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Key Takeaway
Exercise prehabilitation before breast cancer surgery is safe but lacks significant evidence for reducing postoperative pain.

A meta-analysis of six randomized controlled trials evaluated the effect of exercise-based prehabilitation on postoperative pain in women undergoing breast cancer surgery. The intervention included aerobic, resistance, mobility, and stretching exercises, compared with usual care or education.

For the primary outcome of pain at one month post-surgery, the pooled analysis of three trials (n=157) showed a small, non-significant reduction (SMD = -0.24; 95% CI: -0.55 to 0.08; p = 0.14). This suggests a possible but uncertain benefit.

Secondary outcomes, including quality of life (EORTC QLQ-C30) and shoulder function (SPADI), were assessed, but details were limited. The intervention was reported as safe and feasible, with no adverse events or discontinuations reported.

However, the certainty of evidence is low, and the heterogeneity estimate was based on only three studies, limiting the strength of conclusions. The authors note that while exercise prehabilitation may offer some benefit, the current evidence does not confirm a statistically significant effect on pain.

Clinicians may consider exercise prehabilitation as a safe adjunct, but should not expect guaranteed pain reduction based on this analysis.

How this fits prior evidence

This meta-analysis extends prior coverage on perioperative analgesia in breast cancer surgery by examining a non-pharmacologic intervention. While erector spinae plane block and paravertebral plane block showed comparable analgesic efficacy, exercise prehabilitation did not demonstrate a statistically significant reduction in postoperative pain. The small effect size and low certainty align with the cautious framing of other supportive interventions. It also complements nutritional and community-based strategies by addressing functional preparation, though the non-significant result contrasts with the more definitive findings in those areas.

Surgery for breast cancer is a major milestone, and managing the pain that follows is a top priority for many patients. Some experts have looked into whether specific types of exercise before surgery, called prehabilitation, can help patients cope better during their recovery. This included a mix of aerobic, resistance, mobility, and stretching exercises.

Researchers looked at data from several trials involving hundreds of women. They found that while these exercise programs were safe and feasible for patients to do, the results for reducing pain one month after surgery were not statistically significant. This means the study did not find a clear, consistent drop in pain levels compared to standard care.

Because the evidence is currently of low certainty and the data was varied, it is hard to say exactly how much of an impact exercise has on pain. However, the fact that these programs are safe and easy to follow means they remain a practical option for patients who want to strengthen their bodies before their procedure.

What this means for you:
Exercise before breast cancer surgery is safe and feasible, though it did not show a significant reduction in pain.

Common questions

Is it safe for me to exercise before my breast cancer surgery?

Yes, the research indicates that exercise-based prehabilitation, which includes aerobic, resistance, mobility, and stretching, was reported as safe and feasible for women undergoing breast cancer surgery. While the study did not show a statistically significant reduction in pain one month after surgery, the program was well-tolerated by the participants.

What kind of exercises are included in prehabilitation?

Prehabilitation programs for these patients typically include a variety of movements. These include aerobic exercise, resistance training, mobility work, and stretching. These different types of movement are intended to prepare the body for the upcoming surgery and the recovery process.

Will these exercises definitely reduce my pain after surgery?

The study found a small but non-significant effect on pain one month after surgery. Because the evidence is currently of low certainty, it is not possible to say for certain how much these exercises will reduce your specific pain levels. You should talk to your doctor about how these exercises might fit into your personal care plan.

Study Details

Study typeMeta analysis
EvidenceLevel 1
Follow-up2.1 mo
PublishedSep 2026
View Original Abstract ↓
BACKGROUND: Postoperative pain is a common complication following breast cancer surgery, adversely influencing recovery and quality of life. Exercise-based prehabilitation, initiated before surgery to enhance physical readiness, has shown benefits in other surgical settings. However, its specific impact on postoperative pain in breast cancer patients remains unclear. METHODS: This systematic review and meta-analysis evaluated the effectiveness of exercise-based prehabilitation in reducing postoperative pain in women undergoing breast cancer surgery. Following PRISMA guidelines, a comprehensive search was conducted in PubMed, Scopus, and Web of Science up to June 2025 (search conducted prior to submission). Eligible studies were randomized controlled trials (RCTs) comparing exercise-based prehabilitation with usual care or educational interventions. The primary outcome was pain at one month post-surgery. Risk of bias was assessed using the Cochrane RoB 2 tool, and methodological quality via the TESTEX scale. RESULTS: Six RCTs (n = 519) were included in the qualitative synthesis, and three (n = 157) in the meta-analysis. Interventions varied in duration (1-9 weeks), modality (aerobic, resistance, mobility, stretching), and supervision. Pain was measured using tools such as VAS, NPRS, EORTC QLQ-C30 and SPADI. Meta-analysis showed a small, non-significant effect (SMD = -0.24; 95% CI: -0.55 to 0.08; p = 0.14). Heterogeneity was statistically low (I² = 0%; 95% CI: 0% to 79%), although this estimate was based on only three studies and should not be interpreted as evidence of true consistency across trials. CONCLUSIONS: Exercise-based prehabilitation was reported as safe and feasible in the included studies, with a possible but non-significant benefit in reducing postoperative pain. Given the low certainty of evidence, further high-quality RCTs are needed to clarify its role in breast cancer surgical care.
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