Longitudinal relationships between habitual physical activity and pain tolerance in the general population

Årnes, Anders Pedersen; Nielsen, Christopher Sivert; Stubhaug, Audun; Fjeld, Mats Kirkeby; Johansen, Aslak; Morseth, Bente; Strand, Bjørn Heine; Wilsgaard, Tom; Steingrímsdóttir, Ólöf Anna

doi:10.1371/journal.pone.0285041

Cited by 6 publications

(1 citation statement)

References 53 publications

(70 reference statements)

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“…Also, we evaluated behavioral data only at baseline, not during or just upon the CPT, while they could be measurably modified and further influence pain response. Data from RA were most probably biased by the imposed limit of 4 min immersion time, which could impact all performed analyses ( Årnes et al, 2023 ).…”

Section: Study Limitationsmentioning

confidence: 99%

Response to experimental cold-induced pain discloses a resistant category among endurance athletes, with a distinct profile of pain-related behavior and GABAergic EEG markers: a case–control preliminary study

Peier,

Mouthon,

De Pretto

et al. 2024

Front. Neurosci.

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Pain is a major public health problem worldwide, with a high rate of treatment failure. Among promising non-pharmacological therapies, physical exercise is an attractive, cheap, accessible and innocuous method; beyond other health benefits. However, its highly variable therapeutic effect and incompletely understood underlying mechanisms (plausibly involving the GABAergic neurotransmission) require further research. This case–control study aimed to investigate the impact of long-lasting intensive endurance sport practice (≥7 h/week for the last 6 months at the time of the experiment) on the response to experimental cold-induced pain (as a suitable chronic pain model), assuming that highly trained individual would better resist to pain, develop advantageous pain-copying strategies and enhance their GABAergic signaling. For this purpose, clinical pain-related data, response to a cold-pressor test and high-density EEG high (Hβ) and low beta (Lβ) oscillations were documented. Among 27 athletes and 27 age-adjusted non-trained controls (right-handed males), a category of highly pain-resistant participants (mostly athletes, 48.1%) was identified, displaying lower fear of pain, compared to non-resistant non-athletes. Furthermore, they tolerated longer cold-water immersion and perceived lower maximal sensory pain. However, while having similar Hβ and Lβ powers at baseline, they exhibited a reduction between cold and pain perceptions and between pain threshold and tolerance (respectively −60% and − 6.6%; −179.5% and − 5.9%; normalized differences), in contrast to the increase noticed in non-resistant non-athletes (+21% and + 14%; +23.3% and + 13.6% respectively). Our results suggest a beneficial effect of long-lasting physical exercise on resistance to pain and pain-related behaviors, and a modification in brain GABAergic signaling. In light of the current knowledge, we propose that the GABAergic neurotransmission could display multifaceted changes to be differently interpreted, depending on the training profile and on the homeostatic setting (e.g., in pain-free versus chronic pain conditions). Despite limitations related to the sample size and to absence of direct observations under acute physical exercise, this precursory study brings into light the unique profile of resistant individuals (probably favored by training) allowing highly informative observation on physical exercise-induced analgesia and paving the way for future clinical translation. Further characterizing pain-resistant individuals would open avenues for a targeted and physiologically informed pain management.

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Section: Study Limitationsmentioning

confidence: 99%

Response to experimental cold-induced pain discloses a resistant category among endurance athletes, with a distinct profile of pain-related behavior and GABAergic EEG markers: a case–control preliminary study

Peier,

Mouthon,

De Pretto

et al. 2024

Front. Neurosci.

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Activité physique et tolérance à la douleur au cours des rhumatismes inflammatoires chroniques

Makhlouf,

El Mabrouk,

Miladi

et al. 2023

Revue du Rhumatisme

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Does pain tolerance mediate the effect of physical activity on chronic pain in the general population? The Tromsø Study

Årnes,

Fjeld,

Stigum

et al. 2024

Pain

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Knowledge is needed regarding mechanisms acting between physical activity (PA) and chronic pain. We investigated whether cold pain tolerance mediates an effect of leisure-time physical activity on the risk of chronic pain 7 to 8 years later using consecutive surveys of the population-based Tromsø Study. We included participants with information on baseline leisure-time PA (LTPA) and the level of cold pressor–assessed cold pain tolerance, who reported chronic pain status at follow-up as any of the following: chronic pain for ≥3 months, widespread chronic pain, moderate-to-severe chronic pain, or widespread moderate-to-severe chronic pain. We included 6834 participants (52% women; mean age, 55 years) in counterfactual mediation analyses. Prevalence decreased with severity, for example, 60% for chronic pain vs 5% for widespread moderate-to-severe chronic pain. People with one level higher LTPA rating (light to moderate or moderate to vigorous) at baseline had lower relative risk (RR) of 4 chronic pain states 7 to 8 years later. Total RR effect of a 1-level LTPA increase was 0.95 (0.91-1.00), that is, −5% decreased risk. Total effect RR for widespread chronic pain was 0.84 (0.73-0.97). Indirect effect for moderate-to-severe chronic pain was statistically significant at RR 0.993 (0.988-0.999); total effect RR was 0.91 (0.83-0.98). Statistically significantly mediated RR for widespread moderate-to-severe chronic pain was 0.988 (0.977-0.999); total effect RR was 0.77 (0.64-0.94). This shows small mediation of the effect of LTPA through pain tolerance on 2 moderate-to-severe chronic pain types. This suggests pain tolerance to be one possible mechanism through which PA modifies the risk of moderate-to-severe chronic pain types with and without widespread pain.

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Longitudinal relationships between habitual physical activity and pain tolerance in the general population

Cited by 6 publications

References 53 publications

Response to experimental cold-induced pain discloses a resistant category among endurance athletes, with a distinct profile of pain-related behavior and GABAergic EEG markers: a case–control preliminary study

Response to experimental cold-induced pain discloses a resistant category among endurance athletes, with a distinct profile of pain-related behavior and GABAergic EEG markers: a case–control preliminary study

Activité physique et tolérance à la douleur au cours des rhumatismes inflammatoires chroniques

Does pain tolerance mediate the effect of physical activity on chronic pain in the general population? The Tromsø Study

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