Abstract
Exercise is often used for pain rehabilitation but the link between physical activity level and pain sensitivity is still not fully understood. Pressure pain sensitivity to cuff algometry and conditioned pain modulation (CPM) were evaluated in highly active men (n=22), normally active men (n=26), highly active women (n=27) and normally active women (n=23) based on the Godin Leisure-Time Exercise Questionnaire. Cuff pressure pain sensitivity was assessed at the arm and lower leg. The subjects scored the pain intensity on an electronic Visual Analogue Scale (VAS) during ten minutes with 25 kPa constant cuff pressure and two minutes with zero pressure. The maximal VAS score and area under the VAS-curve were extracted. Pressure pain thresholds (PPT) were recorded by manual pressure algometry on the ipsilateral tibialis anterior muscle before, during and after the tonic arm stimulation. Tonic cuff stimulation of the arm and leg resulted in higher VAS peak scores in women compared with men (p<0.04). In all groups the PPTs were reduced during and after the cuff stimulation compared with baseline (p=0.001). PPT were higher in men compared with women (p=0.03) and higher in highly physical active compared with normal active (p=0.048). Besides the well-known gender difference in pressure pain sensitivity this study demonstrates that a high physical fitness degree in non-athletic subjects is associated with increased pressure pain thresholds but does not affect cuff pressure pain sensitivity in healthy people.
Highlights
Regular physical training is believed to have beneficial effects on general health and cardiovascular risk, there is sufficient evidence to recommend physical training as a treatment modality for patients with chronic musculoskeletal pain [1,2]
Several studies have investigated the relationship between sex and pressure pain sensitivity and most results find that females have significantly lower pain thresholds than males [14,15]
Four groups were defined based on sex and physical activity level; highly active men (HAM; n = 22), normally active men (NAM; n = 26), highly active women (HAW; n = 27) and normally active women (NAW; n = 23)
Summary
Regular physical training is believed to have beneficial effects on general health and cardiovascular risk, there is sufficient evidence to recommend physical training as a treatment modality for patients with chronic musculoskeletal pain [1,2]. Athletes seem to develop long-term alterations in pain perception mainly demonstrated as increased tolerance to mechanical stimuli, whereas pain thresholds show inconsistent changes in comparison to normally active control subjects [8]. There are recent results suggesting that the endogenous pain inhibitory system may be less responsive in athletes during conditioned pain stimulation using tonic heat as test stimuli and the cold-pressor task as conditioning stimuli [9] potentially due to an already active descending inhibitory control. Several studies have investigated the relationship between sex and pressure pain sensitivity and most results find that females have significantly lower pain thresholds than males [14,15]. The aim of this explorative study was to investigate single-point and cuff pressure-pain sensitivity comparing four groups of healthy non-athletic subjects based on sex and level of physical activity
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