Not a Painless Condition: Rheumatological and Musculoskeletal Symptoms in Type 2 Diabetes, and the Implications for Exercise Participation

Cox, Emily R.; Coombes, Jeff S.; Keating, Shelley E.; Burton, Nicola W.; Coombes, Brooke K.

doi:10.2174/1573399815666190531083504

Cited by 8 publications

(12 citation statements)

References 108 publications

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“…One factor may be transient increases in pain or other potential adverse events that may occur during exercise training [69,74]. These events are likely underreported in the current literature and the literature base would benefit from reporting adverse events that can accompany exercise training, including, as suggested by Cox and associated (2020), rheumatological and musculoskeletal symptoms [78]. In general, there is a need for more systematic and rigorous investigations that include consistent pain measures to better compare across studies, larger sample sizes, control groups to account for common confounding variables, and comparison studies to help provide specific exercise prescriptions.…”

Section: Discussionmentioning

confidence: 99%

Exercise and Neuropathic Pain: A General Overview of Preclinical and Clinical Research

Leitzelar

Koltyn

2021

Sports Med - Open

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Neuropathic pain is a disease of the somatosensory system that is characterized by tingling, burning, and/or shooting pain. Medication is often the primary treatment, but it can be costly, thus there is an interest in understanding alternative low-cost treatments such as exercise. The following review includes an overview of the preclinical and clinical literature examining the influence of exercise on neuropathic pain. Preclinical studies support the hypothesis that exercise reduces hyperalgesia and allodynia in animal models of neuropathic pain. In human research, observational studies suggest that those who are more physically active have lower risk of developing neuropathic pain compared to those who are less active. Exercise studies suggest aerobic exercise training (e.g., 16 weeks); a combination of aerobic and resistance exercise training (e.g., 10–12 weeks); or high-intensity interval training (e.g., 15 weeks) reduces aspects of neuropathic pain such as worst pain over the past month, pain over the past 24 h, pain scores, or pain interference. However, not all measures of pain improve following exercise training (e.g., current pain, heat pain threshold). Potential mechanisms and future directions are also discussed to aid in the goal of understanding the role of exercise in the management of neuropathic pain. Future research using standardized methods to further understanding of the dose of exercise needed to manage neuropathic pain is warranted.

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Section: Discussionmentioning

confidence: 99%

Exercise and Neuropathic Pain: A General Overview of Preclinical and Clinical Research

Leitzelar

Koltyn

2021

Sports Med - Open

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“…Chronic painful diabetic peripheral neuropathy can cause symptoms that last for years, severely impairing functional activities, and consequently the quality of life ( Cox et al, 2020b ; Daousi et al, 2004 ). The benefits of physical exercise for the prevention and management of type-II diabetes are well established ( Palermi et al, 2020 ), but there is little knowledge on the specific effects of exercise training on chronic pain for this condition ( Cox et al, 2020a ).…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, the interest of HIIT in exercise prescription in the scientific literature is growing. Even if HIIT led to an important decrease in pain in all the selected articles for this review, in some of them no significant difference with MICT were observed ( Cox et al, 2020a ).…”

Section: Discussionmentioning

confidence: 96%

High-intensity interval training for chronic pain conditions: a narrative review

Botta¹,

Palermi²,

Tarantino³

2022

J Exerc Rehabil

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Chronic pain is defined as pain that persists past the normal healing time. Physical activity and exercise programs are increasingly being promoted and used for a variety of chronic pain conditions. Evidence suggests that physical exercise is an intervention with few adverse events that may improve pain severity and physical function, thus improving the quality of life. High-intensity interval training (HIIT) has been shown to improve physical outcome measures and to decrease disorder-related disability in people with chronic disorders. Since an overview of the benefits of HIIT on chronic pain conditions has not been published yet, this review aims to report the effects of HIIT alone or in combination with other forms of training on different kind of chronic pain conditions. A search in the main scientific electronic databases was performed. The results of the studies included in this review showed that HIIT is beneficial for several chronic pain conditions, improving pain and physical function. Since HIIT could represent a valid help to conventional drug therapies, it could improve the quality of life of these subjects. The actual quality of evidence remains very low, and further high evidence studies are needed to confirm the promising outcomes reported in this review.

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“…Limitations of the study include the small sample size and exploratory investigation of the effects of exercise training on self-reported symptoms. A lack of validated instruments exist to capture the multidimensional and multisite nature of symptoms experienced by people with type 2 diabetes [2]. As widespread chronic pain is common in people with type 2 diabetes, we summed pain intensity scores across nine areas of the body as an index of global pain intensity.…”

Section: Discussionmentioning

confidence: 99%

“…The benefits of physical exercise for the prevention and management of type 2 diabetes are well established, including improved glucose control, cardiorespiratory fitness, muscular strength, muscle mass, and body composition [1]. In contrast, there is little knowledge on the specific effects of exercise training on chronic pain in this population [2]. This is despite growing evidence that people with type 2 diabetes are more likely to develop a range of rheumatological and musculoskeletal problems, and experience both widespread and neuropathic pain [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Effect of different exercise training intensities on musculoskeletal and neuropathic pain in inactive individuals with type 2 diabetes – Preliminary randomised controlled trial

Cox

Gajanand

Burton

et al. 2020

Diabetes Research and Clinical Practice

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People with type 2 diabetes (T2D) have a greater prevalence of musculoskeletal and neuropathic pain. This exploratory analysis investigated whether exercise of different intensities leads to changes in self-reported musculoskeletal pain or symptoms of diabetic neuropathy in inactive individuals with type 2 diabetes. Methods: Thirty-two inactive adults with T2D (59% male, mean age 58.7±9.1yrs, median HbA1c 7.8%) were randomised to usual care (CON), supervised combined aerobic and resistance moderate-intensity continuous training (C-MICT), or supervised combined highintensity interval training (C-HIIT). At baseline and 8-weeks, musculoskeletal and neuropathic pain were evaluated using a modified Nordic Musculoskeletal Questionnaire and the Neuropathy Total Symptom Score-6 respectively. Quantitative sensory testing was used to determine thermal, mechanical and vibration detection thresholds, as well as pain pressure thresholds. Adverse events were recorded throughout the intervention.Results: Compared to CON, reduction in musculoskeletal pain intensity was significantly greater for C-HIIT (MD -5.4, 95% CI [-10.6 to -0.2], p=0.04) and non-significantly greater for C-MICT (MD -5.9 [-12.4 to 0.7], p=0.08). Changes in neuropathy symptoms were not different between C-HIIT and CON (MD 1.0 [-0.9 to 2.8], p=0.31), or C-MICT and CON (MD 0.2 [-3.1 to 3.6], p=0.89). No differences in sensory function were observed between groups. Similar rates of adverse events were seen in both exercise interventions (19 C-HIIT; 17 C-MICT), all but one of which were mild. Conclusions:Preliminary data suggests 8-weeks of high-intensity combined aerobic and resistance exercise may be safely prescribed for inactive individuals with T2D and may reduce musculoskeletal pain but not neuropathic symptoms.

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Not a Painless Condition: Rheumatological and Musculoskeletal Symptoms in Type 2 Diabetes, and the Implications for Exercise Participation

Cited by 8 publications

References 108 publications

Exercise and Neuropathic Pain: A General Overview of Preclinical and Clinical Research

Exercise and Neuropathic Pain: A General Overview of Preclinical and Clinical Research

High-intensity interval training for chronic pain conditions: a narrative review

Effect of different exercise training intensities on musculoskeletal and neuropathic pain in inactive individuals with type 2 diabetes – Preliminary randomised controlled trial

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