Physical activity and cold pain tolerance in the general population

Abstract

Background The relationship between habitual physical activity (PA) and experimental pain tolerance has been investigated in small samples of young, healthy and/or single‐sex volunteers. We used a large, population‐based sample to assess this relationship in men and women with and without chronic pain. Methods We used data from the sixth and seventh Tromsø Study surveys (2007–2008; 2015–2016), with assessed pain tolerance of participants with the cold pressor test (CPT: dominant hand in circulating cold water at 3°C, maximum test time 106 s), and self‐reported total amount of habitual PA in leisure time (n = 19,087), exercise frequency (n = 19,388), exercise intensity (n = 18,393) and exercise duration (n = 18,343). A sub‐sample had PA measured by accelerometers (n = 4,922). We used Cox regression to compare CPT tolerance times between self‐reported PA levels. For accelerometer‐measured PA, we estimated hazard ratios for average daily activity counts, and for average daily minutes of moderate‐to‐vigorous PA done in bouts lasting 10 min or more. Models were tested for PA‐sex, and PA‐chronic pain and PA‐moderate‐to‐severe chronic pain interactions. Results Leisure‐time PA, exercise intensity and exercise duration were positively associated with CPT tolerance (p < .001; p = .011; p < .001). More PA was associated with higher CPT tolerance. At high levels of leisure‐time PA and exercise intensity, men had a significantly higher CPT tolerance than women. Accelerometer‐measured PA was not associated with CPT tolerance. Conclusions This study is one of the first to show that higher self‐reported habitual PA was connected to higher experimental pain tolerance in a population‐based sample, especially for men. This was not found for accelerometer‐measured PA. Significance This study finds that higher level of self‐reported leisure‐time physical activity is associated with increased cold pressor pain tolerance in a large population‐based sample. Though present in both sexes, the association is strongest among men. Despite the robust dose–response relationship between pain tolerance and self‐reported activity level, no such relationship was found for accelerometer‐measured activity, reflecting a possible discrepancy in the aspect of physical activity measured. Though the study design does not permit causal conclusions, the findings suggest that increasing physical activity may increase pain tolerance in the general population.

Psychophysical predictors of experimental muscle pain intensity following fatiguing calf exercise

“…The strongest predictor of pain intensity during DOMS was cPTT. Higher baseline tolerance was associated with lower DOMS severity, which is consistent with literature, showing lower pain tolerance thresholds generally to be present in chronic pain populations [64,65] associated with non-recovery after injury [66] and clinical pain intensity [67], development of persistent post-operative pain [68,69], various other health-related factors including analgesic consumption [70] and lack of physical activity [71]. Compared to pain detection thresholds, pain tolerance has long been thought to reflect more cognitive-evaluative aspects [72].…”

Positive affect and distraction enhance whereas negative affect impairs pain modulation in patients with recurrent low back pain and matched controls

“…12 However, these thresholds are commonly reported to represent different constructs, with pain tolerance showing more consistent relation to cognitive-evaluative features like pain-related fear and expectations, 43 personality traits, 23 and other general health markers. 2,51 In relation to CPM, significant differences between controls and patients with RLBP were not observed. This is not consistent with CPM findings from the usual ramped cuff paradigm published previously in this cohort 32 nor with prior meta-analyses showing generally reduced efficacy of CPM in LBP.…”

“…12 However, these thresholds are commonly reported to represent different constructs, with pain tolerance showing more consistent relation to cognitive-evaluative features like pain-related fear and expectations, 43 personality traits, 23 and other general health markers. 2,51…”

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

“…A single bout of aerobic exercise may lead to exercise-induced hypoalgesia (EIH) in healthy controls (10), but for patients with chronic pain it may, on the contrary, be less efficient or increase pain sensitivity (8). A more enduring hypoalgesia has been suggested as a feature associated with increased levels of habitual PA for healthy people (11). Lower sensitivity to experimental pressure pain is significantly associated with male sex and more habitual self-reported PA (11)(12)(13)(14).…”

“…A more enduring hypoalgesia has been suggested as a feature associated with increased levels of habitual PA for healthy people (11). Lower sensitivity to experimental pressure pain is significantly associated with male sex and more habitual self-reported PA (11)(12)(13)(14). Habitual PA and aerobic training may generally influence pain perception (11,15,16).…”