Chronic pain is often associated with impaired muscle strength and limited physical activity and performance, resulting in impaired physical functioning. This study aimed to determine whether voluntary participation in a structured 6-week hydrotherapy exercise programme would improve pain management, functionality and quality of life in an elderly population (n = 22; 77.7 ± 6.6 y)suffering from chronic pain and living in nursing homes in Tshwane. The experimental group (n= 13) attended hydrotherapy classes twice a week for six weeks, while the control group (n = 9)did not. Questionnaires were completed (Chronic Pain Grade, Functional Status Index, and the SF 36), and functional testing performed, in both groups at weeks 0, 3 and 6. The experimental group reported reduced pain intensity at week 3 (p = 0.051); reduced pain-induced disability at week 6 (p = 0.080); reduced assisted help required for activities of daily living (ADL) at week 3 (p = 0.040); reduced difficulty on performing ADL at week 3 (p = 0.012) and reduced pain experienced with ADL at week 3 (p = 0.007) and week 6 (p = 0.014). Improvements in upper body strength and agility were demonstrated. Improvements in sub-scales for quality of life were demonstrated at weeks 3 and 6. The control group showed no statistically significant changes in the above parameters. In conclusion, participation in structured hydrotherapy classes has been shown in this small study to be a beneficial intervention strategy for managing chronic pain in the elderly.