Researchers from institutions including the University of Southern Denmark and the Chiropractic Knowledge Hub analysed data from 2,787 adult Copenhagen residents who participated in a questionnaire survey and health check between 2011 and 2015. Participants reported their physical activity levels both during leisure time and at work, ranging from inactive/sedentary work to high levels of activity across four response categories. They also indicated whether they had experienced persistent or recurring pain over the past six months, and where in the body the pain occurred.
Clear Difference Between Leisure and Work
The results show that:
More leisure-time activity = lower odds of persistent pain in muscles and joints: Individuals with low moderate to high levels of physical activity during leisure time had 42–62% lower odds of persistent pain and up to 26% fewer pain regions compared to inactive individuals.
More physical activity at work = higher odds: High physical activity at work was associated with nearly triple the odds (OR 2.94) of persistent pain and 78% more pain points compared to sedentary work.
Combination matters: The most protective combination was moderate-to-high leisure-time exercise and sedentary work. In contrast, low leisure-time activity combined with high physical workload resulted in up to 98% more pain points.
Why Is There a Difference?
Researchers point out that physical activity during leisure time is typically short-term, varied, and allows for proper recovery, which strengthens muscles and the cardiovascular system over time. Physical activity at work, on the other hand, is often prolonged, repetitive, and characterized by heavy lifting, awkward postures, and repetitive movements – all known risk factors for pain. Additionally, high physical demands at work combined with low autonomy and high stress levels may also play a significant role in the development of pain.
Relevance for Clinical Practice
The study highlights that not all physical activity is beneficial for the musculoskeletal system. For chiropractors and other healthcare professionals, this means:
- Ask about both leisure-time and work-related physical activity during patient history taking.
- Patients with physically demanding jobs should be advised to find a healthy balance between exercise and movement during leisure time, physical activity at work, recovery, and sleep.
Conclusion
While leisure-time physical activity appears to protect against persistent pain, physically demanding work may increase the risk. For many Danes with physically strenuous jobs, targeted physical activity during leisure time may therefore be an important component in both the treatment and prevention of persistent pain in muscles and joints.
Melker S. Johansson, Jan Hartvigsen, Mette Korshøj, Magnus T. Jensen, Andreas Holtermann, Karen Søgaard. The leisure time and occupational physical activity paradox in persistent musculoskeletal pain. Scientific Reports 2025.
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