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Therapy & Technology

Smartwatch and Pain — What Your Watch Can Really Do for You

6 min read••Philippe Banaszak
Apple Watch, Garmin, Fitbit, Oura Ring — millions of people now wear devices that track their sleep, heart rate and steps. But can this data really help with chronic pain? The scientific answer is fascinating: it's not the watch that relieves pain — it's the movement it encourages. At our practice in Eupen, we use these technologies as rehabilitation allies. Here's how to get the most out of your smartwatch.

No, your watch doesn't cure pain

Let's bust a widespread myth: no wearable device has a direct pain-relieving effect. Your smartwatch is not a medication. The scientific literature is clear: using an activity tracker alone has no direct, significant impact on pain intensity.But — and this is the good news — research equally shows that activity trackers drive a clinically meaningful and lasting increase in physical activity, across all age groups. And it is precisely this increase in movement that triggers profound neurophysiological pain modulation mechanisms.In other words: the watch is not the medicine. The watch is the compass that guides you to the medicine — movement.

Movement — your natural painkiller

When you move regularly, your body activates a fascinating defence system: exercise-induced hypoalgesia. This scientifically documented phenomenon works through several pathways simultaneously:Natural painkillers — Moderate exercise stimulates the release of endorphins and endocannabinoids, substances produced by your body that significantly reduce your pain sensitivity.Anti-fear effect — Movement activates the reward circuit in your brain while simultaneously inhibiting fear responses. Regular movement thus helps overcome the fear of moving.Anti-inflammatory brake — Physical activity reduces chronic inflammation at the cellular level and restores nervous system balance.A large study of over 11,000 participants showed that just 80 minutes of walking per day reduces the risk of chronic low back pain by 13%. From 100 minutes, the reduction reaches 23%.

Follow the trend, not the number

"The best use of your smartwatch? Compare yourself today to yourself last week — never to a standard or someone else."
This is the rule that changes everything. Science shows that different brands don’t speak the same language: Apple Watch measures heart rate variability differently from Garmin, and Fitbit differently from Oura Ring. Values are not comparable between devices.But each device is reliable on its own for tracking your personal trends over weeks and months. If your step count steadily rises, if your sleep improves, if your recovery progresses — you’re on the right track. Regardless of the absolute number.Forget the "10,000 steps per day" rule. This target is not scientifically based and can be discouraging. Start from your current average and increase it by 40 to 60% over several weeks.

3 smart habits for your smartwatch

  1. Watch your step trend over 7 days** — Note your current weekly average. Then increase it gradually: from 4,500 to 6,000, then to 7,000 steps per day. Research shows that just a 40% increase already produces measurable improvements in chronic pain. No jumps — steady progression.
  2. Use your recovery data in the morning** — On waking, check your heart rate variability (HRV) or your "Body Battery"/"Readiness Score". Is it lower than your personal average? Choose gentle movement rather than intense training. This helps you avoid setbacks.
  3. Trust the sleep trend, not the score** — Sleep scores can fluctuate wildly day-to-day and are sometimes inaccurate. What matters: are you sleeping more on average than last week? Waking less often? That’s your real progress.

When to pay attention

Your smartwatch provides valuable clues — but it is not a doctor. Here are situations where the data should prompt you to act:• Your HRV drops for several days running while your resting heart rate rises simultaneously — this may indicate excessive stress, poor sleep or early inflammation. Reduce your intensity.• You’ve suddenly doubled or tripled your activity — Research shows that a ratio above 1.5 between your current week’s load and the average of the past 4 weeks significantly increases the risk of a pain flare-up. Gradual progression is key.• Your pain worsens despite increasing activity — Sometimes the nervous system needs time to adapt with chronic pain. If the worsening persists, consult a physiotherapist in Eupen who can adjust your programme.• Your watch repeatedly flags "unusual heart rate" — Have it checked by a doctor. Detecting heart rhythm disorders is one of the strongest clinically validated smartwatch features.

At Praxis Loten — Technology serving therapy

At our practice in Eupen, we actively integrate your smartwatch data into your therapy. Here’s how we use it:Objective baseline — At your first appointment, we can analyse your average step count, sleep rhythm and recovery indicators from recent weeks. This gives us a realistic picture of your daily life — beyond recall biases.Personalised goals — No "10,000 steps for everyone". We calculate your individual progression based on your real data and scientific thresholds.Load management — For athletes and active patients, we use the ratio between current and chronic workload to prevent setbacks and ensure safe rehabilitation.Shared progress — Your data transforms the consultation: instead of "How do you feel?", we can say together "Let’s look at what’s changed". This strengthens your trust in your own body.Bring your smartwatch to your next appointment at Praxis Loten — among many ways we can support you.

This article is for informational purposes only and does not replace medical or physiotherapy advice. If pain persists or worsens, consult a healthcare professional.

References

  1. 1Yerramalli et al. Volume and Intensity of Walking and Risk of Chronic Low Back Pain. Med Sci Sports Exerc. 2024;56(2):260-267.
  2. 2Amorim AB et al. Can Wearable Devices Promote Physical Activity and Reduce Pain in People with Chronic Musculoskeletal Conditions? A Systematic Review. J Clin Med. 2023;14(3):1003.
  3. 3Lima LV et al. Exercise-Induced Hypoalgesia: Cellular and Molecular Mechanisms. Cells. 2022;15(10):858.
  4. 4Giles D et al. Pedometer-driven Walking for Chronic Low Back Pain: A Feasibility Randomized Controlled Trial. Clin Rehabil. 2017;31(4):480-489.
  5. 5Düking P et al. Validity of Heart Rate Variability Measured with Apple Watch Series. Sensors. 2022;22(18):6784.