Can chronic pain be alleviated by regular exercise?

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A study including more than 10,000 adults demonstrated that those who regularly maintained moderate to intense physical activity during the study period reported greater pain tolerance.

This study was referred to by some researchers as of high importance due to the long follow-up of the participants, for 7 to 8 years.

On the other hand, the importance of this study grows when we observe that many of us suffer from chronic pain.

“Staying still” does not help us.

And one more important finding from the study: even light exercise was associated with greater pain tolerance.

The study’s principal investigator, Dr. Anders Pederson Arnes, reported that there was evidence that the amount of physical activity over time and the change in activity level was important for greater pain tolerance. All of this points to the possibility that increased physical activity may increase pain tolerance.

However, any level of physical activity is better than none.

Therefore, we should encourage those closest to us to observe at least some physical activity, especially for those with some level of chronic pain. And we must not forget that the elderly should be encouraged to practice physical exercises daily.

Study results were based on pain tolerance measured by the cold pressure test, which measured the longest time participants kept their hands submerged in ice water. Test tolerance was 7%, 14%, and 16% higher, respectively, for participants in the light, moderate, and intense exercise groups compared to the sedentary group.

Doctor Arnes said that “any kind of activity over time is better than being sedentary”. And he added that “engaging in habitual physical activity in leisure time is associated with greater pain tolerance.”

But how to explain these results?

Aerobic exercise is believed to be an effective intervention in chronic low back pain (CLBP), although its mechanisms remain largely untested.

A recent study evaluated whether endogenous opioid (EO) mechanisms could contribute to the analgesic effects of an aerobic exercise intervention for CLBP. The results seem to indicate that aerobic exercises, in the absence of other interventions, seem to be effective for the control of CLBP. This study seems likely to demonstrate that the benefits of aerobic exercise are related to endogenous pain inhibition, in part, to endogenous opioid mechanisms.

It’s never too late for changes.

Returning to the study by Arnes and colleagues, these researchers further found that people who were sedentary at baseline and who reported greater physical activity during the follow-up study also had greater pain tolerance compared to those who remained sedentary. ; this finding, however, was not statistically significant.

This greater pain tolerance was observed in people, who engaged in moderate to intense exercise over time, performing 20.4 seconds more on the cold press test than those who were consistently sedentary (statistically significant result — p<0.001).

There was no significant difference in pain tolerance between men and women.

Study results indicate that a positive change in physical activity level over time was associated with greater pain tolerance.

So it seems that total activity level can define how much more pain tolerant you will be prepared and more activity seems to be better.

Although this study explored the relationship between general levels of physical activity and a form of acute pain; data from other studies indicate that there is benefit for other forms of pain.

This suggests that exercise is beneficial for individuals living with pain, as Prof. Cohen.

There are, however, questions about how exercise might affect chronic pain tolerance or risk, and investigations are ongoing.

Your doctor can best advise you on the type of physical activity and intensity you can engage in. Talk to him.

It is important that “you move”.

Walking is the most common form of aerobic exercise recommended for people with chronic pain.

References

• ARNES AP et al (2023) — PloS ONE 18(5): e0285041 https: //doi.org/10.1371/journal.pone.0285041 — May 24, 2023
• BRUEHL S et al — PAIN 161(12):p 2887–2897, December 2020. | DOI: 10.1097/j.pain.0000000000001969
• BURTON KW — Medscape May 31, 2023
• NAUGLE KM — Pract Pain Manag 2016; 16(9)