Details

Autor(en) / Beteiligte

• Rice, David
• Nijs, Jo
• Kosek, Eva
• Wideman, Timothy
• Hasenbring, Monika I
• Koltyn, Kelli
• Graven-Nielsen, Thomas
• Polli, Andrea

Titel

Exercise-Induced Hypoalgesia in Pain-Free and Chronic Pain Populations: State of the Art and Future Directions

Ist Teil von

• The journal of pain, 2019-11, Vol.20 (11), p.1249-1266

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2019

Quelle

Elsevier ScienceDirect Journals Complete

Beschreibungen/Notizen

• •Aerobic and resistance exercise typically lead to hypoalgesia in pain-free adults.•Exercise may lead to hypoalgesia or hyperalgesia in people with chronic pain.•Several different factors may influence the effect of exercise on pain. Exercise is considered an important component of effective chronic pain management and it is well-established that long-term exercise training provides pain relief. In healthy, pain-free populations, a single bout of aerobic or resistance exercise typically leads to exercise-induced hypoalgesia (EIH), a generalized reduction in pain and pain sensitivity that occurs during exercise and for some time afterward. In contrast, EIH is more variable in chronic pain populations and is more frequently impaired; with pain and pain sensitivity decreasing, remaining unchanged or, in some cases, even increasing in response to exercise. Pain exacerbation with exercise may be a major barrier to adherence, precipitating a cycle of physical inactivity that can lead to long-term worsening of both pain and disability. To optimize the therapeutic benefits of exercise, it is important to understand how EIH works, why it may be impaired in some people with chronic pain, and how this should be addressed in clinical practice. In this article, we provide an overview of EIH across different chronic pain conditions. We discuss possible biological mechanisms of EIH and the potential influence of sex and psychosocial factors, both in pain-free adults and, where possible, in individuals with chronic pain. The clinical implications of impaired EIH are discussed and recommendations are made for future research, including further exploration of individual differences in EIH, the relationship between exercise dose and EIH, the efficacy of combined treatments and the use of alternative measures to quantify EIH. This article provides a contemporary review of the acute effects of exercise on pain and pain sensitivity, including in people with chronic pain conditions. Existing findings are critically reviewed, clinical implications are discussed, and recommendations are offered for future research.