Endocannabinoid and Opioid System Interactions in Exercise-Induced Hypoalgesia

Crombie, Kevin M.; Brellenthin, Angelique G.; Hillard, Cecilia J.; Koltyn, Kelli F.

doi:10.1093/pm/pnx058

Cited by 81 publications

(67 citation statements)

References 26 publications

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“…Studies have also shown that intense exercise is followed by an increase in heat-pain thresholds, a phenomenon termed "exercise induced analgesia" (EIA; Scheef et al, 2012;Koltyn, Brellenthin, Cook, Sehgal, & Hillard, 2014;Crombie, Brellenthin, Hillard, & Koltyn, 2017). Although EIA lasts up to 30 min (Hoffman et al, 2004), perhaps its effects are cumulative, namely the EIA of athletes is constantly on an "on" mode, whereas it has an "on" and "off" modes among non-athletes, depending on the frequency/intensity of their exercises.…”

Section: Basal Pain Perception Of Athletesmentioning

confidence: 99%

The type of sport matters: Pain perception of endurance athletes versus strength athletes

Assa

Geva

Zarkh

et al. 2018

European Journal of Pain

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Background Studies assessing athletes’ pain sensitivity yield inconsistent data, which demonstrate either increased pain threshold and tolerance in athletes than controls or similar thresholds. This inconsistency may result from the variability in the type of sport practiced by the athletes and its effect on pain perception. For example, endurance athletes perform continuous intense exercise for prolonged durations, whereas strength athletes perform short bouts of extreme efforts. Consequently, endurance athletes may tolerate and modulate pain better than strength athletes. This hypothesis was tested by comparing pain perception of endurance athletes with that of strength athletes. Methods Subjects were 19 endurance athletes (triathletes), 17 strength athletes (weightlifters and throwers) and 17 non‐athlete controls. Quantitative measurements included heat‐pain threshold, heat‐pain tolerance, cold pressor pain ratings, temporal summation of pain (TSP) and conditioned pain modulation (CPM). Fear of pain and pain catastrophizing were also assessed. Results The two athlete groups had lower pain ratings than non‐athletes. However, strength athletes had higher heat‐pain threshold than endurance athletes, whereas endurance athletes had higher heat‐pain tolerance and stronger CPM than strength athletes and lower fear of pain levels. Longer training time correlated with TSP in endurance athletes but with CPM and heat‐pain tolerance in strength athletes. Conclusions Although athletes in general seem less responsive to noxious stimuli than non‐athletes, the type of sport differentially affects pain perception; whereas endurance‐based sport is associated with improved pain inhibition, strength‐based sport is associated with reduced pain sensitivity. These characteristics may be considered when sport is recommended for pain management. Significance This study shows that different sport types are associated with different characteristics of pain perception and modulation, as well as of thoughts towards pain.

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Section: Basal Pain Perception Of Athletesmentioning

confidence: 99%

The type of sport matters: Pain perception of endurance athletes versus strength athletes

Assa

Geva

Zarkh

et al. 2018

European Journal of Pain

View full text Add to dashboard Cite

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“…The key mechanisms in exercise-induced hypoalgesia may include opioid and non-opioid systems (e.g. the endocannabinoid system) 7 , 8 .…”

Section: Introductionmentioning

confidence: 99%

The interplay of exercise, placebo and nocebo effects on experimental pain

Colloca

Corsi

Fiorio

2018

Sci Rep

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Over the last few decades, placebo, and nocebo effects in general, have been investigated at rest. This proposed study explores whether they could work even when the experience of pain occurs during a movement. Exercise itself can have a hypoalgesic effect, suggesting that placebo- and exercise-induced hypoalgesia could foster pain reduction. In the present study, we investigated the interplay of exercise, placebo and nocebo effects on pain. To this aim, we developed a machine-controlled isotonic motor task to standardize the exercise across participants and used a well-validated model of placebo and nocebo manipulations with reinforced expectations via a conditioning procedure including visual cues paired with heat painful stimulations. Participants reported expectations and pain on a trial-by-trial basis. We found that the standardized isotonic exercise elicited a reduction of pain intensity. Moreover, both exercise and placebo induced comparable hypoalgesic effects. When the exercise was added, placebo and nocebo effects were influenced by expectations but were not affected by fatigue or sex differences. Exercise-, placebo- and nocebo-induced pain modulation are likely to work through distinct mechanisms and neurophysiological research is needed to fully exploit the implications for sport, rehabilitation and pain management.

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“…This is known to evoke Type IV (C-fiber) temporal pain summation. The same group also focussed on molecular parameters of pain, especially the involvement of endocannabinoid markers 10,25 . Furthermore, conditioned pain modulation has been proposed to examine central pain inhibitory processing 26 .…”

Section: Discussionmentioning

confidence: 99%

Sub-maximal endurance exercise does not mediate alterations of somatosensory thresholds

Kortenjann

Banzer

Fleckenstein

2020

Sci Rep

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physical exercise has been shown to alter sensory functions, such as sensory detection or perceived pain. However, most contributing studies rely on the assessment of single thresholds, and a systematic testing of the sensory system is missing. this randomised, controlled cross-over study aims to determine the sensory phenotype of healthy young participants and to assess if sub-maximal endurance exercise can impact it. We investigated the effects of a single bout of sub-maximal running exercise (30 min at 80% heart rate reserve) compared to a resting control in 20 healthy participants. The sensory profile was assessed applying quantitative sensory testing (QST) according to the protocol of the German Research Network on Neuropathic Pain. QST comprises a broad spectrum of thermal and mechanical detection and pain thresholds. it was applied to the forehead of study participants prior and immediately after the intervention. time between cross-over sessions was one week. Submaximal endurance exercise did not significantly alter thermal or mechanical sensory function (time × group analysis) in terms of detection and pain thresholds. The sensory phenotypes did not indicate any clinically meaningful deviation of sensory function. the alteration of sensory thresholds needs to be carefully interpreted, and only systematic testing allows an improved understanding of mechanism. in this context, sub-maximal endurance exercise is not followed by a change of thermal and mechanical sensory function at the forehead in healthy volunteers. Exercise-induced changes of the somatosensory profile have led to controversial discussions, in particular with regards to their effect on pain. Exercise has been shown to induce hypoalgesia in healthy subjects 1 , however, it can also induce hyperalgesia in certain chronic diseases or following exertion 2. Its effects in people with clinical pain are rather variable. In patients with neuropathic pain, exercise is considered to improve nerve function, reduce pain and other sensory dysfunction, and improve static and dynamic functional mobility 3. However, in patients with musculoskeletal pain, manual therapies on stability failed to achieve a significant pain reduction 4. A recent systematic review suggests an association between psychosocial factors and exercise-induced hypoalgesia in healthy subjects, and in patients with musculoskeletal pain 5. This is further supported by a proposed central mechanism underlying these two phenomena, such as the increased activation of NMDA receptors in pain-modulating areas 6. Exercise-induced hypoalgesia, i.e. pain reduction, can be achieved by both aerobic and resistance training, of which the latter achieves larger mean effect sizes 7. Aerobic exercise is more likely to induce generalised hypoalgesia, whereas resistance exercise is related to locoregional effect sites 1. Higher aerobic intensities (200 W or 60-75% oxygen uptake) appear more effective in mediating hypoalgesia. Isometric exercise was shown to decrease the intensity of experimental pain at lo...

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Endocannabinoid and Opioid System Interactions in Exercise-Induced Hypoalgesia

Cited by 81 publications

References 26 publications

The type of sport matters: Pain perception of endurance athletes versus strength athletes

The type of sport matters: Pain perception of endurance athletes versus strength athletes

The interplay of exercise, placebo and nocebo effects on experimental pain

Sub-maximal endurance exercise does not mediate alterations of somatosensory thresholds

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