Association between physical activity and pain processing in adults with chronic low back pain compared to pain-free controls

Orr, Lindsay C.; George, Steven Z.; Simon, Corey B.

doi:10.3233/bmr-150429

Cited by 16 publications

(12 citation statements)

References 35 publications

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“…However, if chronic pain is already present, this might, in some cases, sensitize individuals to pain in such a way as to act contrary to the benefits of PA on pain sensitivity. Indeed, the presence of chronic pain has been reported to coincide with a lacking, or even reversed, association between habitual PA and pain sensitivity (Mani et al., 2019; Orr et al., 2017), and identical acute exercise regimens can produce different central pain processing responses across different painful conditions (Meeus et al., 2015). It is therefore of interest to further assess how the presence of chronic pain might influence the relationship between levels of habitual PA and the experience of painful stimuli.…”

Section: Introductionmentioning

confidence: 99%

Physical activity and cold pain tolerance in the general population

Årnes

Nielsen

Stubhaug

et al. 2020

European Journal of Pain

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Background The relationship between habitual physical activity (PA) and experimental pain tolerance has been investigated in small samples of young, healthy and/or single‐sex volunteers. We used a large, population‐based sample to assess this relationship in men and women with and without chronic pain. Methods We used data from the sixth and seventh Tromsø Study surveys (2007–2008; 2015–2016), with assessed pain tolerance of participants with the cold pressor test (CPT: dominant hand in circulating cold water at 3°C, maximum test time 106 s), and self‐reported total amount of habitual PA in leisure time (n = 19,087), exercise frequency (n = 19,388), exercise intensity (n = 18,393) and exercise duration (n = 18,343). A sub‐sample had PA measured by accelerometers (n = 4,922). We used Cox regression to compare CPT tolerance times between self‐reported PA levels. For accelerometer‐measured PA, we estimated hazard ratios for average daily activity counts, and for average daily minutes of moderate‐to‐vigorous PA done in bouts lasting 10 min or more. Models were tested for PA‐sex, and PA‐chronic pain and PA‐moderate‐to‐severe chronic pain interactions. Results Leisure‐time PA, exercise intensity and exercise duration were positively associated with CPT tolerance (p < .001; p = .011; p < .001). More PA was associated with higher CPT tolerance. At high levels of leisure‐time PA and exercise intensity, men had a significantly higher CPT tolerance than women. Accelerometer‐measured PA was not associated with CPT tolerance. Conclusions This study is one of the first to show that higher self‐reported habitual PA was connected to higher experimental pain tolerance in a population‐based sample, especially for men. This was not found for accelerometer‐measured PA. Significance This study finds that higher level of self‐reported leisure‐time physical activity is associated with increased cold pressor pain tolerance in a large population‐based sample. Though present in both sexes, the association is strongest among men. Despite the robust dose–response relationship between pain tolerance and self‐reported activity level, no such relationship was found for accelerometer‐measured activity, reflecting a possible discrepancy in the aspect of physical activity measured. Though the study design does not permit causal conclusions, the findings suggest that increasing physical activity may increase pain tolerance in the general population.

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Section: Introductionmentioning

confidence: 99%

Physical activity and cold pain tolerance in the general population

Årnes

Nielsen

Stubhaug

et al. 2020

European Journal of Pain

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“…using a vacuum cleaner) and sports and exercise (Public Health England, ; World Health Organization, ). Physical inactivity has been strongly associated with the development and exacerbation of chronic health problems, including diabetes mellitus, ischaemic heart disease, cancer (Lee et al, ) and musculoskeletal complaints such as neck pain (Hallman, Ekman, & Lyskov, ), low back pain (Orr, George, & Simon, ) and lower limb osteoarthritis (Stubbs, Hurley, & Smith, ). To date, no review has been published that synthesizes the possible association of physical (in)activity in the development of WRUQDs across multiple occupational settings.…”

Section: Introductionmentioning

confidence: 99%

Physical activity participation and the association with work‐related upper quadrant disorders (WRUQDs): A systematic review

Mansfield

Thacker

Smith

2017

Musculoskeletal Care

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“…Similar to this study, a recent study demonstrated no relationships between moderate or vigorous PA levels and heat-evoked TS of pain in a group of individuals with low back pain. 59 Lack of null relationships between MTS and PA/SB measures in this study can be due to observations: lower and skewed MTS change score at the symptomatic site (mean [SD]: 1.9 [1.8]); skewed PA data; inter-regional TS differences (lower scores—neck/shoulder regions vs higher scores at low back/knee/hip regions); higher MTS-S scores in older adults group (vs <65 years); and higher MTS at the painful site (vs remote site). Besides, there is some evidence demonstrating hypoesthesia in the painful region and no signs of CS, 30,35 which may have influenced the TS responses in the symptomatic region.…”

Section: Discussionmentioning

confidence: 99%

“…23,33,34 Moreover, no associations were found between pain processing measures and PA levels in individuals with chronic low back pain, suggesting a potential confounding of relationship by psychosocial factors. 59 Therefore, it is essential to understand the PA relationships with various clinical markers of nociceptive processing and modulatory processes while taking into account a range of confounding factors such as pain catastrophizing and sleep quality. 5,6,33,34,74,76…”

Section: Introductionmentioning

confidence: 99%

“…Evidence of the relationship between PA levels and nociceptive modulatory mechanisms in chronic musculoskeletal pain is scarce. 41,59 Insights on these mechanistic relationships may help to design solutions to optimize PA in individuals with musculoskeletal pain. Therefore, this cross-sectional study aimed to investigate the association between self-reported PA and SB levels and measures of nociceptive processing and modulatory mechanisms in a cohort of adults with chronic musculoskeletal pain.…”

Section: Introductionmentioning

confidence: 99%

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Sedentary behaviour facilitates conditioned pain modulation in middle-aged and older adults with persistent musculoskeletal pain: a cross-sectional investigation

Mani

Adhia

Leong

et al. 2019

PR9

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Introduction:Higher physical activity (PA) and lower sedentary behaviour (SB) levels have demonstrated beneficial effects on temporal summation (TS) and conditioned pain modulation (CPM) in healthy adults. This cross-sectional study investigated the relationships between PA and SB and TS/CPM responses in individuals with chronic musculoskeletal pain.Methods:Sixty-seven middle-aged and older adults with chronic musculoskeletal pain were recruited from the community. Questionnaires measuring demographics, pain, and psychological measures were completed. Physical activity/SB levels were measured using the International Physical Activity Questionnaire—short form and Sedentary Behaviour Questionnaire, respectively. Semmes monofilament was used to assess mechanical TS (MTS) at the most symptomatic (MTS-S) and a reference region (MTS-R); change in the pain scores (baseline-10th application) was used for analysis. Conditioned pain modulation procedure involved suprathreshold pressure pain threshold (PPT-pain4) administered before and after (CPM30sec, CPM60sec, and CPM90sec) conditioning stimulus (2 minutes; ∼12°C cold bath immersion). For analysis, PPT-pain4 (%) change scores were used.Results:PPT-pain4 (%) change scores at CPM30sec and CPM60sec demonstrated significant weak positive correlations with SB levels and weak negative correlations with PA measures. After adjusting for confounding variables, a significant positive association was found between SB (h/d) and PPT-pain4 (%) change scores at CPM30sec and CPM60sec. No significant associations between MTS and PA/SB measures.Conclusion:Sedentariness is associated with higher pain inhibitory capacity in people with chronic musculoskeletal pain. The observed relationship may be characteristic of a protective (sedentary) behaviour to enhance pain modulatory mechanism. Prospective longitudinal studies using objective PA/SB measures are required to validate the observed relationship in a larger sample size.

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Association between physical activity and pain processing in adults with chronic low back pain compared to pain-free controls

Cited by 16 publications

References 35 publications

Physical activity and cold pain tolerance in the general population

Physical activity and cold pain tolerance in the general population

Physical activity participation and the association with work‐related upper quadrant disorders (WRUQDs): A systematic review

Sedentary behaviour facilitates conditioned pain modulation in middle-aged and older adults with persistent musculoskeletal pain: a cross-sectional investigation

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