Pain Tolerance in Chronic Pain Patients Seems to be More Associated with Physical Activity than with Depression and Anxiety

Abstract

Objective: To explore the associations between habitual self-reported physical activity, pain sensitivity and patient-reported outcomes (including pain intensity) in patients with chronic pain. Design: Cross-sectional, experimental study. Subjects: Patients (n = 78), age range 18–65 years, with different chronic pain conditions (> 3 months) were compared with age- and gender-matched healthy controls (n = 98). Methods: Multivariate correlations between self-reported physical activity, pressure pain thresholds, and patient-reported outcome measures were assessed. Results: Lower perceived health status (p < 0.001, Cohen’s d = 2.34), higher levels of depression (p < 0.001, Cohen’s d = 1.77), and lower pressure pain tolerance threshold (p < 0.001, Cohen’s d = 1.66) were the most prominent variables discriminating patients from controls. In patients, bivariate and multivariate analyses showed that higher pressure pain tolerance was associated with male gender, lower pain intensity and fewer painful regions, higher self-efficacy and more self-reported physical activity, but not with lower levels of anxiety and depression. Conclusion: Pressure pain tolerance thresholds, as well as degree of depression and perceived health status discriminated between patients and controls, and there was an association between pain tolerance and level of self-reported physical activity in patients. This study highlights the importance of further research into how increased physical activity may improve pain sensitivity in patients with chronic pain.

Development of a Clinical Prediction Rule for Treatment Success with Transcranial Direct Current Stimulation for Knee Osteoarthritis Pain: A Secondary Analysis of a Double-Blind Randomized Controlled Trial

“…The presence of physical variables in our final model suggests that not only are the emotional components relevant in predicting a treatment's success, but so are the physical aspects of health. Previous research has explored the relationship between different levels of physical activity with pain perception and central pain processing [104,105]. It has been suggested that higher levels of self-reported physical activity or health are associated with better function of the endogenous pain inhibitory system and lower self-reported pain, while the opposite is associated with a more sedentary lifestyle [105][106][107][108][109][110][111][112][113][114][115][116].…”

“…It has been suggested that higher levels of self-reported physical activity or health are associated with better function of the endogenous pain inhibitory system and lower self-reported pain, while the opposite is associated with a more sedentary lifestyle [105][106][107][108][109][110][111][112][113][114][115][116]. In fact, pain tolerance in chronic pain has been suggested to be more associated with physical activity than with emotional factors, such as depression and anxiety [104]. It is known that participation in regular physical activity offers global benefits in terms of motor cortex function, including an enhanced capacity for neuroplasticity and motor learning [109], and the evidence supports the concept of the motor cortex as an important modulator for chronic pain [110][111][112].…”

Chronic Pain and Comorbid Depression: A Narrative Review

“…In a similar study entitled "Pain tolerance in chronic pain patients seems to be more associated with physical activity than with depression and anxiety", adults with different pain conditions were included (N =78) [23]. A lower pain tolerance threshold was noted in patients with pain conditions versus controls.…”

Investigation of factors influencing low physical activity levels in community-dwelling older adults with chronic pain: a cross-sectional study

“…Kinesiophobia and pain tolerance thresholds also in uence low physical activity levels in adults with CP [7,8]. However, all previous studies have compared CP groups with healthy controls and thus have not compared individuals with CP with different levels of physical activity.…”