Vaegter HB, et al. - Given that pain is a complex and profoundly subjective phenomenon that can be modulated by several factors, researchers conducted this narrative review examining the pain modulatory effects of exercise, stress, and cognition in humans. As per experimental studies on the effect of exercise, pain-free participants exhibit a hypoalgesic response after exercise. However, this response is reduced or even hyperalgesic in nature in some patients with chronic pain. Another modulator of the pain experience is stress. Although acute stress may induce hypoalgesia, many patients with chronic pain conditions may have detrimental effects on pain in presence of ongoing clinical stress; this may have implications for the understanding, assessment, and treatment of stress in patients with pain. Finally, they identified the differing roles of cognitive strategies in pain inhibition. A review of two intuitive strategies, thought suppression and focused distraction, will be performed as regards experimental, acute, and chronic pain.