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Association between physical activity and pain processing in adults with chronic low back pain compared to pain-free controls

Abstract

BACKGROUND:

Pain sensitivity has been negatively associated with physical activity levels. Few studies have examined associations between experimentally induced pain sensitivity and physical activity in adults with chronic low back pain and pain-free controls.

OBJECTIVE:

The objective of this study was to examine associations between physical activity levels and how an individual processes pain using experimentally induced pain stimuli.

METHODS:

Seventy subjects (CLBP = 49; mean age = 46.8 ± 14.9; Pain-free = 21; mean age = 45.3 ± 18.2, n of females = 46) participated. A self-report questionnaire derived from the International Physical Activity Questionnaire (IPAQ) was used to calculate an activity level index. Pain sensitivity was assessed via quantitative sensory testing (QST) at the right lower extremity.

RESULTS:

Moderate (U = 688, p< 0.05) and vigorous (U = 649, p< 0.05) physical activity levels were higher in pain-free vs. individuals with CLBP. Activity level was not associated with pain sensitivity (Pain-free: R2 = 0.02, p> 0.05; CLBP: R2 = 0.01, p> 0.05). Both moderate (R2 = 0.49, p< 0.05) and vigorous (R2 = 0.68, p< 0.01) physical activity were associated with pain modulation amongst pain-free individuals.

CONCLUSIONS:

Findings suggest that physical activity influences pain modulation amongst pain-free individuals, however no relationship exists once CLBP is present. However, future investigation will elucidate the extent to which physical activity level either prevents CLBP or is effective in alleviating CLBP.

References

[1] 

Hoy D, , March L, , Brooks P, et al. The global burden of low back pain: Estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014 Jun; 73(6): 968-74.

[2] 

Buchbinder R, , Blyth FM, , March LM, , Brooks P, , Woolf AD, , Hoy DG. Placing the global burden of low back pain in context. Best Pract Res Clin Rheumatol. 2013; 27(5): 575-589.

[3] 

Lautenbacher S, , Kunz M, , Strate P, , Nielsen J, , Arendt-Nielsen L. Age effects on pain thresholds, temporal summation and spatial summation of heat and pressure pain. Pain. 2005; 115(3): 410-418.

[4] 

Wiesenfeld-Hallin Z. Sex differences in pain perception. Gend Med. 2005; 2(3): 137-145.

[5] 

Pauli P, , Rau H, , Zhuang P, , Brody S, , Birbaumer N. Effects of smoking on thermal pain threshold in deprived and minimally-deprived habitual smokers. Psychopharmacology (Berl). 1993; 111(4): 472-476.

[6] 

Vassend O, , Røysamb E, , Nielsen CS. Five-factor personality traits and pain sensitivity: A twin study. Pain. 2013; 154(5): 722-728.

[7] 

Chen SM, , Liu MF, , Cook J, , Bass S, , Lo SK. Sedentary lifestyle as a risk factor for low back pain: A systematic review. Int Arch Occup Environ Health. 2009 Jul; 82(7): 797-806.

[8] 

Heneweer H, , Staes F, , Aufdemkampe G, , van Rijn M, , Vanhees L. Physical activity and low back pain: A systematic review of recent literature. Eur Spine J. 2011 Jun; 20(6): 826-45. doi: 10.1007/s00586-010-1680-7. Epub 2011 Jan 9. Review.

[9] 

Heneweer H, , Vanhees L, , Picavet HS. Physical activity and low back pain: a U-shaped relation? Pain. 2009 May; 143(1-2): 21-5.

[10] 

Strawbridge WJ, , Deleger S, , Roberts RE, , Kaplan GA. Physical activity reduces the risk of subsequent depression for older adults. Am J Epidemiol. 2002 Aug 15; 156(4): 328-34.

[11] 

Nijs J, , Van Houdenhove B, , Oostendorp RA. Recognition of central sensitization in patients with musculoskeletal pain: Application of pain neurophysiology in manual therapy practice. Man Ther. 2010; 15(2): 135-141.

[12] 

Price DD, , Staud R, , Robinson ME, , Mauderli AP, , Cannon R, , Vierck CJ. Enhanced temporal summation of second pain and its central modulation in fibromyalgia patients. Pain. 2002; 99(1-2): 49-59.

[13] 

Nir RR, , Yarnitsky D. Conditioned pain modulation. Curr Opin Support Palliat Care. 2015 Jun; 9(2): 131-7.

[14] 

Clauw DJ, , Williams D, , Lauerman W, , Dahlman M, , Aslami A, , Nachemson AL, , Kobrine AI, , Wiesel SW. Pain sensitivity as a correlate of clinical status in individuals with chronic low back pain. Spine (Phila Pa 1976).

[15] 

Giesecke T, , Gracely RH, , Grant MA, , Nachemson A, , Petzke F, , Williams DA, , Clauw DJ. Evidence of augmented central pain processing in idiopathic chronic low back pain. Arthritis Rheum. 2004 Feb; 50(2): 613-23.

[16] 

Puta C, , Schulz B, , Schoeler S, , Magerl W, , Gabriel B, , Gabriel HH, , Miltner WH, , Weiss T. Enhanced sensitivity to punctate painful stimuli in female patients with chronic low back pain. BMC Neurol. 2012 Sep 21; 12: 98.

[17] 

Imamura M, , Chen J, , Matsubayashi SR, , Targino RA, , Alfieri FM, , Bueno DK, , Hsing WT. Changes in pressure pain threshold in patients with chronic nonspecific low back pain. Spine (Phila Pa 1976). 2013 Nov 15; 38(24): 2098-107.

[18] 

Tesarz J, , Wolfgang E, , Treede RD, , Gerhardt A. Altered pressure pain thresholds and increased wind-up in adult chronic back pain patients with a history of childhood maltreatment: A quantitative sensory testing study. Pain. 2016 Apr 13. [Epub ahead of print]

[19] 

Mlekusch S, , Neziri AY, , Limacher A, , Jüni P, , Arendt-Nielsen L, , Curatolo M. Conditioned Pain Modulation in Patients With Acute and Chronic Low Back Pain. Clin J Pain. 2016 Feb; 32(2): 116-21.

[20] 

Geva N, , Defrin R. Enhanced pain modulation among triathletes: A possible explanation for their exceptional capabilities. Pain. 2013; 154(11): 2317-2323.

[21] 

Naugle KM, , Riley 3rd, , Joseph L. Self-reported Physical Activity Predicts Pain Inhibitory and Facilitatory Function. Medicine & Science in Sports & Exercise. 2014; 2013; 46: 622-629.

[22] 

Tesarz J, , Schuster AK, , Hartmann M, , Gerhardt A, , Eich W. Pain perception in athletes compared to normally active controls: A systematic review with meta-analysis. Pain. 2012; 153(6): 1253-1262.

[23] 

Craig CL, , Marshall AL, , Sjöström M, , Bauman AE, , Booth ML, , Ainsworth BE, , Pratt M, , Ekelund U, , Yngve A, , Sallis JF, , Oja P. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003 Aug; 35(8): 1381-95.

[24] 

Ferreira-Valente MA, , Pais-Ribeiro JL, , Jensen MP. Validity of four pain intensity rating scales. Pain. 2011 Oct; 152(10): 2399-404.

[25] 

Cdc.gov. Measuring Physical Activity Intensity [Internet]. 2015 [cited 16 July 2015]. Available from: http://www.cdc. gov/physicalactivity/basics/measuring/index.html.

[26] 

Haskell WL, , Lee IM, , Pate RR, , Powell KE, , Blair SN, , Franklin BA, , Macera CA, , Heath GW, , Thompson PD, , Bauman A. American College of Sports Medicine; American Heart Association. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007 Aug 28; 116(9): 1081-93.

[27] 

Robinson ME, , Bialosky JE, , Bishop MD, , Price DD, , George SZ. Supra-threshold scaling, temporal summation, and after-sensation: relationships to each other and anxiety/fear. J Pain Res. 2010; 3: 25-32.

[28] 

Valencia C, , Fillingim RB, , George SZ. Suprathreshold heat pain response is associated with clinical pain intensity for patients with shoulder pain. J Pain. 2011; 12(1): 133-140.

[29] 

Valencia C, , Kindler LL, , Fillingim RB, , George SZ. Investigation of central pain processing in shoulder pain: converging results from 2 musculoskeletal pain models. J Pain. 2012; 13(1): 81-89.

[30] 

Price DD, , Hu JW, , Dubner R, , Gracely RH. Peripheral suppression of first pain and central summation of second pain evoked by noxious heat pulses. Pain. 1977; 3(1): 57-68.

[31] 

Crombez G, , Eccleston C, , Van Damme S, , Vlaeyen JW, , Karoly P. Fear-avoidance model of chronic pain: the next generation. Clin J Pain. 2012 Jul; 28(6): 475-83.

[32] 

Geva N, , Defrin R. Enhanced pain modulation among triathletes: A possible explanation for their exceptional capabilities. Pain. 2013; 154(11): 2317-2323.

[33] 

Naugle KM, , Riley 3rd, , Joseph L. Self-reported Physical Activity Predicts Pain Inhibitory and Facilitatory Function. Medicine & Science in Sports & Exercise. 2014; 2013; 46: 622-629.

[34] 

Cotman CW, , Berchtold NC. Exercise: A behavioral intervention to enhance brain health and plasticity. Trends Neurosci. 2002; 25: 295-301.

[35] 

Tesarz J, , Schuster AK, , Hartmann M, , Gerhardt A, , Eich W. Pain perception in athletes compared to normally active controls: A systematic review with meta-analysis. Pain. 2012; 153(6): 1253-1262.

[36] 

Arendt-Nielsen L, , Yarnitsky D. Experimental and clinical applications of quantitative sensory testing applied to skin, muscles and viscera. J Pain. 2009; 10(6): 556-572.