Exercise-induced hypoalgesia after acute and regular exercise: 2020 Vaegter, Jones

[Sly Saint]

Exercise-induced hypoalgesia after acute and regular exercise: experimental and clinical manifestations and possible mechanisms in individuals with and without pain

Exercise and physical activity is recommended treatment for a wide range of chronic pain conditions. In addition to several well-documented effects on physical and mental health, 8 to 12 weeks of exercise therapy can induce clinically relevant reductions in pain. However, exercise can also induce hypoalgesia after as little as 1 session, which is commonly referred to as exercise-induced hypoalgesia (EIH).

In this review, we give a brief introduction to the methodology used in the assessment of EIH in humans followed by an overview of the findings from previous experimental studies investigating the pain response after acute and regular exercise in pain-free individuals and in individuals with different chronic pain conditions.

Finally, we discuss potential mechanisms underlying the change in pain after exercise in pain-free individuals and in individuals with different chronic pain conditions, and how this may have implications for clinical exercise prescription as well as for future studies on EIH.

https://journals.lww.com/painrpts/F...e_induced_hypoalgesia_after_acute_and.11.aspx

mentions fibromyalgia and chronic fatigue syndrome and ME/CFS

 

[alktipping]

methods are deeply flawed subjective testing always leads to unreliable and easily biased conclusions .

 

[James Morris-Lent]

Did anybody not know that pain tolerance is increased during and a bit after 'exercise'? This is a virtually universal human experience - if you've ever been healthy and, say, played a sport.

In fairness to the authors they point out that this tends to get screwed up in a lot of conditions:

In individuals with different chronic pain conditions, the response to a single session of exercise is less consistent as hypoalgesia, reduced hypoalgesia, or even hyperalgesia (ie, increased sensitivity to pain) has been observed. As illustrated in Table 2, hypoalgesia after exercise has, eg, been observed in individuals with chronic musculoskeletal pain,123,197 shoulder pain,105 patella femoral pain,180 knee osteoarthritis,59,194 menstrual pain,186 and rheumatoid arthritis.117 However, reduced EIH responses or even hyperalgesia after exercise has often been demonstrated in individuals with whiplash-associated disorder,203 ME/CFS,123,202 fibromyalgia pain,100,107,177 painful diabetic neuropathy,90 chronic musculoskeletal pain,19 and also in a delayed-onset muscular soreness pain model.

It certainly could make sense to study the (patho)physiology of this phenomenon. However you obviously can't directly harness it clinically unless you endeavor to have patients constantly chased a cougar or something.

 

[rvallee]

It certainly could make sense to study the (patho)physiology of this phenomenon. However you obviously can't directly harness it clinically unless you endeavor to have patients constantly chased a cougar or something.

I don't think you'd have difficulty recruiting with that but the participants may be a bit confused.

 

[Wonko]

Am I misunderstanding something?

Have they found that, contrary to the alleged normal experience of healthy people, if they take someone who has damaged joints (due to say arthritis) and make them pointlessly and repeatedly mobilise that joint, then these people report an increase in pain, rather than a decrease.

And then done the same with other categories of people with various medical issues which would suggest that pointless and repetitive movement would probably cause pain?

What's next, taking people with shattered legs and then noting that attempting to run 'hurts'?

 

[Invisible Woman]

Hypoalgesia, hyperalgesia - how d'you objectively measure that then? How can you tell what's the right amount of pain?

When healthy and getting fit or if I'd been on a long project or on holiday that interfered with my usual exercise I would expect some pain as I got back into it. However, unless I'd twisted or sprained something this pain was typically eased by movement. Even more telling, there was less pain at the next session and not more.

It seems to me that trying to test hyper or hypo when it comes to pain is a little absurd.

The location, type of pain, how long that pain lasts and looking at what if anything eases it are all better things to look at. Though none of it is an actual measure as such.