Pain In Community-dwelling Older Adults Research Articles

Predictors, Protective Factors, and Adverse Outcomes of Joint Pain among Malaysian Community-Dwelling Older Adults: Findings from the LRGS-TUA Longitudinal Study.

Background: Joint pain has been recognized as one of the major causes of limitations in mobility, functional decline, and consequently declined quality of life in older adults. Hence, this study aimed to identify the predictors, protective factors, and adverse outcomes of joint pain in community-dwelling older adults. Methods: In this Long-term Research Grant Scheme-Towards Useful Ageing (LRGS-TUA) longitudinal study, a total of 1005 older participants aged 60 years and above who were successfully followed up after five years were included in the analysis. The participants self-reported their joint pain status at baseline and during the fifth year. Subsequently, the baseline characteristics were used to predict changes in joint pain status. Adverse outcomes related to joint pain were evaluated based on the participants' joint pain statuses. Results: Results showed that being female, having diabetes mellitus, and higher body mass index were associated with the incidence of joint pain. Meanwhile, increased intake of pantothenic acid and higher levels of blood albumin levels were associated with recovery from joint pain. Participants with persistent joint pain at baseline and follow-up showed higher levels of depression and disability compared to individuals who never experience any joint pain. However, participants who had recovered from joint pain did not differ significantly from those without joint pain at baseline and follow-up in these measures. Conclusions: By identifying the modifiable risk factors, factors associated with recovery, and adverse outcomes related to joint pain, this study adds to current evidence that may contribute to further management strategies for joint pain in older adults.

Association Between Domain-Specific Physical Activity and Chronic Low Back Pain in Community-Dwelling Older Adults: A Cross-Sectional Study.

To investigate the association between physical activity (PA) domains and chronic low back pain (LBP) in older adults. A cross-sectional study where sociodemographic, behavioral, and health variables; PA; and presence of chronic LBP were collected. Higher scores of PA defined the "more active" participants. Binary logistic regression was used to test the association between PA domains and chronic LBP. A total of 516 participants were included. The mean age was 71.8 (95% confidence interval, CI, [71.1, 72.5]) years, and 29%, 27%, 25%, and 31% were identified as "more active" in the household, sports, leisure-time, and total PA domains, respectively. "More active"participants in sports (odds ratio = 0.62, 95% CI [0.40, 0.97]), leisure-time (odds ratio = 0.54, 95% CI [0.35, 0.85]) and total (odds ratio = 0.60, 95% CI [0.39, 0.92]) PA domains were less likely to report chronic LBP. High levels of sports, leisure-time, and total PA were inversely associated with chronic LBP.

Preventive Effect of an Intervention Program with Increased Physical Activity on the Development of Musculoskeletal Pain in Community-Dwelling Older Adults: A Randomized Controlled Trial: A Critical Analysis.

Journal Article Accepted manuscript Preventive Effect of an Intervention Program with Increased Physical Activity on the Development of Musculoskeletal Pain in Community-Dwelling Older Adults: A Randomized Controlled Trial: A Critical Analysis Get access John Andre Socci, B.S. Fordham University John Andre Socci, B.S. Fordham University Department of Medicine, Rowan University School of Osteopathic Medicine, Stratford, NJ Corresponding author: John Andre Socci, OMS-1, B.S. Fordham University, Department of Medicine, Rowan School of Osteopathic Medicine, Address: 1 Medical Center Dr, Stratford, NJ 08084, Phone: (908) 339 8025, Fax:(908) 339 8025, Email: soccij24@rowan.edu. https://orcid.org/0009-0001-0181-7157 Search for other works by this author on: Oxford Academic PubMed Google Scholar Pain Medicine, pnad084, https://doi.org/10.1093/pm/pnad084 Published: 22 June 2023 Article history Received: 29 May 2023 Accepted: 15 June 2023 Published: 22 June 2023

Reply to Letter to the Editor regarding "Preventive effect of an intervention program with increased physical activity on the development of musculoskeletal pain in community-dwelling older adults: a randomized controlled trial".

Journal Article Accepted manuscript Reply to Letter to the Editor regarding “Preventive effect of an intervention program with increased physical activity on the development of musculoskeletal pain in community-dwelling older adults: a randomized controlled trial” Get access Tatsuya Hirase, PhD, Tatsuya Hirase, PhD Division of Physical Therapy Science, Graduate Course of Health and Social Work, Kanagawa University of Human Services, Kanagawa, Japan Corresponding author: Tatsuya Hirase, PhD, Division of Physical Therapy Science, Graduate Course of Health and Social Work, Kanagawa University of Human Services, 1-10-1 Heisei-cho, Yokosuka, Kanagawa, Japan, Tel: +81 46 828 2730; Fax: +81 46 828 2731; Email: hirase-rx7@kuhs.ac.jp. Search for other works by this author on: Oxford Academic PubMed Google Scholar Shigeru Inokuchi, PhD, Shigeru Inokuchi, PhD Department of Physical Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar Minoru Okita, PhD Minoru Okita, PhD Department of Physical Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar Pain Medicine, pnad082, https://doi.org/10.1093/pm/pnad082 Published: 20 June 2023 Article history Received: 12 June 2023 Accepted: 15 June 2023 Published: 20 June 2023

Association between the empirical dietary inflammatory index and musculoskeletal pain in community-dwelling older adults: a cross-sectional study.

Inflammation has been proposed to be one of the main causes of musculoskeletal pain. Diet is a lifestyle factor that plays an important role in managing inflammation; thus, we assessed the inflammatory potential of diets using the empirical dietary inflammatory index (EDII) to investigate the relationship between diet and musculoskeletal pain. This cross-sectional study included 212 elderly individuals who were selected from health centers in Tehran, Iran. Dietary intake was evaluated using a valid and reliable 147-item food frequency questionnaire. To measure the intensity of pain, a visual analogue scale was used. Multiple linear regression was applied to assess the association between the EDII and musculoskeletal pain. In total, 62.7% and 37.3% of participants had mild and severe pain, respectively. The EDII values were 0.97±0.72 and 1.10±0.66, respectively, in those with mild and severe pain. A higher EDII score was associated with more intense musculoskeletal pain after adjusting for age and sex (β=0.20; 95% confidence interval [CI], 0.06-0.26; p<0.001), but not after adjustment for other confounders (β=-0.13; 95% CI, -1.54 to 0.60; p=0.39). Our findings indicated that higher dietary inflammation might not be associated with musculoskeletal pain in older adults. However, further investigations are required to confirm these findings.

Independent and combined associations of depressive symptoms and sleep disturbance with chronic pain in community-dwelling older adults.

There is limited evidence regarding whether depressive symptoms and sleep disturbance are independently or synergistically associated with chronic pain. We investigated the independent and combined associations of depressive symptoms and sleep disturbance with chronic pain and its severity (and the additive interactions) in community-dwelling older adults. This cross-sectional study analyzed the data of 1374 individuals who were 65 to 75 year old, not in need of long-term care, and completed questionnaires assessing sociodemographic factors, depressive symptoms, sleep disturbance, and chronic pain. The severity of chronic pain was assessed based on pain intensity, pain distribution, and pain type. The participants' status of depressive symptoms and sleep disturbance were categorized in the following 4 groups: neither condition, depressive symptoms alone, sleep disturbance alone, and both conditions. Among the 1374 participants, 849 (61.8%) had chronic pain. The multivariable-adjusted odds ratios and 95% confidence intervals of the presence of chronic pain in those with depressive symptoms alone, sleep disturbance alone, and both conditions were 1.40 (0.97-2.03), 1.98 (1.41-2.78), and 2.12 (1.39-2.23), respectively, compared with the neither-condition group. Similar associations were observed for severe chronic pain. However, there were no significant additive interactions. In addition, only sleep disturbance was significantly associated with chronic pain, after adjusting for depressive symptoms. Our analyses did not reveal a synergistic effect of depressive symptoms and sleep disturbance on chronic pain and its severity, suggesting that most of the effects of depressive symptoms on chronic pain may be mediated by sleep disturbance.

Prevalence of pain in community-dwelling older adults with hypertension in the United States

Hypertension and pain are both prevalent conditions in the older adult population. We aimed to report the prevalence of pain discomforts and investigated the association between hypertension and pain discomforts among older adults in the United States. Data from the 2011 National Health and Aging Trends Study were analyzed. In-person interviews were conducted in 7601 adults ages ≥ 65 years. Prevalence of bothersome pain, activity-limiting pain, locations of pain and usage of pain medicine were evaluated. Demographics, comorbidities, and other covariates were compared between older adults with hypertension and those without. Multivariate regression was further performed to yield adjusted odd ratios. Among 6825 older adults, 4533 of them had a history of hypertension while 2272 of them had not. Prevalence of bothersome pain (57.12% versus 44.81%, p < 0.001) and activity-limiting pain (56.21% versus 46.12%, p < 0.001) were significantly higher in the hypertension group. After adjusting for all covariates, hypertension demonstrated a significant association with activity-limiting pain (OR 1.63, 95% CI 1.06 to 2.52, p = 0.02). In conclusion, pain was more prevalent in older Americans with hypertension. The positive association between hypertension and pain suggested that routine pain assessment and proper treatment would be required to improve the function and quality of life among older adults especially with hypertension.

Chronic Musculoskeletal Pain Moderates the Association between Sleep Quality and Dorsostriatal-Sensorimotor Resting State Functional Connectivity in Community-Dwelling Older Adults

Aging is associated with poor sleep quality, and greater chronic pain prevalence with age-related changes in brain function as potential underlying mechanisms. The following cross-sectional study aimed to determine whether self-reported chronic musculoskeletal pain in community-dwelling older adults moderates the association between sleep quality and resting state functional brain connectivity (rsFC). Community-dwelling older individuals (mean age=73.29 years) part of the NEPAL study who completed the Pittsburg Sleep Quality Index (PSQI) and an rsFC scan were included (n=48) in the present investigation. To that end, we tested the effect of chronic pain-by-PSQI interaction on rsFC among atlas-based brain regions-of-interest, controlling for age and sex. A significant network connecting the bilateral putamen and left caudate with bilateral precentral gyrus, postcentral gyrus and juxtapositional lobule cortex, survived global multiple comparisons (FDR; q<0.05) and threshold-free network-based-statistics. Greater PSQI scores were significantly associated with greater dorsostriatal-sensorimotor rsFC in the no-pain group, suggesting that a state of somatomotor hyperarousal may be associated with poorer sleep quality in this group. However, in the pain group greater PSQI scores were associated with less dorsostriatal-sensorimotor rsFC, possibly due to a shift of striatal functions toward regulation sensorimotor aspects of the pain experience, and/or aberrant cortico-striatal loops in the presence of chronic pain. This preliminary investigation advances knowledge about the neurobiology underlying the associations between chronic pain and sleep in community-dwelling older adults that may contribute to the development of effectitractve therapies to decrease disability in geriatric populations. This work was supported by the National Institutes of Aging (NIAK01AG048259, R01AG059809, R01AG067757, and T32AG049673). A portion of this work was performed in the McKnight Brain Institute at the National High Magnetic Field Laboratory's Advanced Magnetic Resonance Imaging and Spectroscopy (AMRIS) Facility, which is supported by National Science Foundation Cooperative Agreement No. DMR-1644779 and DMR-1157490, and the State of Florida and the University of Florida Claude D. Pepper Older Americans Independence Center.

Chronic Musculoskeletal Pain Moderates the Association between Sleep Quality and Dorsostriatal-Sensorimotor Resting State Functional Connectivity in Community-Dwelling Older Adults.

Aging is associated with poor sleep quality and greater chronic pain prevalence, with age-related changes in brain function as potential underlying mechanisms. Objective. The following cross-sectional study aimed to determine whether self-reported chronic musculoskeletal pain in community-dwelling older adults moderates the association between sleep quality and resting state functional brain connectivity (rsFC). Methods. Community-dwelling older individuals (mean age = 73.29 years) part of the NEPAL study who completed the Pittsburg Sleep Quality Index (PSQI) and a rsFC scan were included (n = 48) in the present investigation. To that end, we tested the effect of chronic pain-by-PSQI interaction on rsFC among atlas-based brain regions-of-interest, controlling for age and sex. Results and Discussion. A significant network connecting the bilateral putamen and left caudate with bilateral precentral gyrus, postcentral gyrus, and juxtapositional lobule cortex, survived global multiple comparisons (FDR; q < 0.05) and threshold-free network-based-statistics. Greater PSQI scores were significantly associated with greater dorsostriatal-sensorimotor rsFC in the no-pain group, suggesting that a state of somatomotor hyperarousal may be associated with poorer sleep quality in this group. However, in the pain group, greater PSQI scores were associated with less dorsostriatal-sensorimotor rsFC, possibly due to a shift of striatal functions toward regulation sensorimotor aspects of the pain experience, and/or aberrant cortico-striatal loops in the presence of chronic pain. This preliminary investigation advances knowledge about the neurobiology underlying the associations between chronic pain and sleep in community-dwelling older adults that may contribute to the development of effective therapies to decrease disability in geriatric populations.

The Association between Bodily Pain and Cognitive Impairment in Community-Dwelling Older Adults.

Background: Bodily pain is a common condition in older adults and interferes with individuals’ cognitive functioning. We aimed to evaluate the association between bodily pain and related locations and cognitive impairment among community-dwelling older adults in Taiwan. Method: In this retrospective, cross-sectional study, we enrolled 2022 participants aged 60‒70 years, from the Taiwan Biobank. Mini-Mental State Examination was performed to assess cognitive impairment. Further, logistic regression analyses were performed to identify the relationship between bodily pain and cognitive impairment. Results: Overall, 161 participants had cognitive impairment. Multivariable analysis showed that older adults who reported bodily pain were more likely than those who did not have cognitive impairment (odds ratio 1.68). Moreover, the occurrence of cognitive impairment correlated with the presence of two or more pain locations and self-reported low back and waist pain or sciatica. Conclusion: Our study revealed that cognitive impairment was associated with bodily pain in community-dwelling older adults, particularly older adults with low back and waist pain or sciatica and those with two or more pain locations. To maintain the quality of older adults’ life, pain and cognitive decline need to be simultaneously assessed with considerably more precise and objective markers.

Non-pharmacological interventions for managing pain in community-dwelling older adults.

Pain is a complex and common issue within older adults. This complexity can be a direct result of comorbidities and the subsequent polypharmacy. The effective control of pain in older adults needs more than just pharmacological management. Non-pharmacological interventions have been demonstrated to be beneficial when combined with pain medications. This commentary critically appraises a systematic review that examines the effectiveness of non-pharmacological interventions for the management of pain in community dwelling older adults.

The Influence of Nordic Walking on Spinal Posture, Physical Function, and Back Pain in Community-Dwelling Older Adults: A Pilot Study.

Nordic walking is an increasingly popular form of exercise among the elderly. Using poles is thought to facilitate a more upright posture; however, previous studies primarily investigated the effects of Nordic walking on respiratory function and physical fitness. The aims of this study were to investigate the influence of Nordic walking on spinal posture, physical functions, and back pain in community-dwelling older adults. Thirty-one community-dwelling older adults aged ≥ 60 years participated in a twice weekly Nordic walking training program for 12 weeks. The outcome measures, including spinal posture, physical functions, back pain, and the strength and endurance of back extensor muscles were assessed before and after a 12-week program. After training, spinal posture, back pain, and the strength and endurance of back extensor muscles did not show any statistically significant changes. Among the seven clinical tests of physical function, only the 30 s arm curl test, the 30 s chair stand test, and the single leg stance test showed significant improvements. Nordic walking has limited influence on age-related hyperkyphosis and back pain, but may be effective for physical function. The results of this study can provide useful information for people involved in the prevention and treatment of physical dysfunction in community-dwelling older adults.

Moderate or severe low back pain is associated with body mass index amongst community-dwelling older Australians

ObjectiveLow back pain is prevalent in older populations and modifiable risk factors may include being overweight or obese. This study aimed to describe the prevalence and impact of moderate or severe low back pain in community-dwelling older adults and its association with body mass index (BMI). MethodsCross-sectional study involving 16,439 Australians aged ≥70 years. Logistic regression was used to describe associations between the presence or absence of moderate or severe low back pain experienced on most days with BMI. Analyses were conducted separately for males and females, and controlled for age and depression at baseline. ResultsOf 14,155 pain question respondents, 11 % of males (n = 710/6475) and 18 % of females (n = 1391/7680) reported moderate or severe low back pain (total 15 %, n = 2101/14,155). Of those reporting moderate or severe low back pain (n = 2101), 55 % reported taking pain-relieving medication regularly, and 29 % reported that the pain regularly interfered with sleep, 37 % with walking, and 47 % with day to day activities. When age and depression were controlled for, there was a statistically significant (p < 0.001) association between moderate or severe low back pain and being overweight (females: odds ratio OR = 1.50, 95 % confidence interval CI = 1.27−1.76) or obese (males: OR = 2.23, 95 %CI = 1.77−2.80 and females: OR = 2.91, 95 %CI = 2.48−3.42). ConclusionModerate or severe low back pain is common, has a significant impact, and is associated with either an overweight or obese BMI among community-dwelling Australians aged ≥70 years.

A systematic review of the evidence for the efficacy of opioids for chronic non-cancer pain in community-dwelling older adults

the ageing global population and concomitant increase in the use of opioid analgesia have highlighted the need to evaluate the effectiveness of opioids for chronic pain in older people. a systematic review of the evidence for the efficacy of opioids for chronic non-cancer pain in community-dwelling people aged 65years or more was conducted using PRISMA guidelines. The databases MEDLINE, EMBASE, Pubmed and PsychINFO were searched. The quality of studies was assessed. Secondary aims were to assess correlates of opioid use and the decision-making processes of prescribers. seven studies were identified of low to high quality. The majority of older people experienced ongoing pain despite continuing opioid therapy. There were mixed results regarding benefits of opioids in terms of activities of daily living and social engagement. In nursing home residents, opioid use at baseline was associated with severe pain, severe impairment in activities of daily living and a diagnosis of depression. Fear of causing harm to older people was common amongst opioid prescribers, limiting prescription. Facilitators of opioid prescription included educational interventions and access to an evidence base for opioid use. there is limited evidence supporting the use of long-term opioid use in older people for chronic non-cancer pain and a lack of trials in this age group. Age-specific guidelines are required addressing initial assessment, indications, monitoring and de-prescribing.

The effectiveness, suitability, and sustainability of non-pharmacological methods of managing pain in community-dwelling older adults: a systematic review

BackgroundPain is common in older adults. To maintain their quality of life and promote healthy ageing in the community, it is important to lower their pain levels. Pharmacological pain management has been shown to be effective in older adults. However, as drugs can have various side effects, non-pharmacological pain management is preferred for community-dwelling older adults. This systematic review evaluates the effectiveness, suitability, and sustainability of non-pharmacological pain management interventions for community-dwelling older adults.MethodsFive databases, namely, CINHAL, Journals@Ovid, Medline, PsycInfo, and PubMed, were searched for articles. The criteria for inclusion were: full-text articles published in English from 2005 to February 2019 on randomized controlled trials, with chronic non-cancer pain as the primary outcome, in which pain was rated by intensity, using non-pharmacological interventions, and with participants over 65 years old, community-dwelling, and mentally competent. A quality appraisal using the Jadad Scale was conducted on the included articles.ResultsTen articles were included. The mean age of the older adults was from 66.75 to 76. The interventions covered were acupressure, acupuncture, guided imagery, qigong, periosteal stimulation, and Tai Chi. The pain intensities of the participants decreased after the implementation of the intervention. The net changes in pain intensity ranged from − 3.13 to − 0.65 on a zero to ten numeric rating scale, in which zero indicates no pain and ten represents the worst pain.ConclusionsNon-pharmacological methods of managing pain were effective in lowering pain levels in community-dwelling older adults, and can be promoted widely in the community.

Immersive Virtual Reality for the Management of Pain in Community-Dwelling Older Adults

Immersive Virtual Reality for the Management of Pain in Community-Dwelling Older Adults

(329) Epigenetic Aging is Associated with Clinical and Experimental Pain in Community-Dwelling Older Adults

Gerontological research reveals considerable interindividual variability in biological aging, which has motivated research efforts to identify ‘aging biomarkers’ that are better predictors of disease risk and residual lifespan when compared to chronological age alone. Emerging evidence using the epigenetic clock as an aging biomarker supports highly reliable individualized predictions about future health and function. The current study focuses on the estimation of “epigenetic age” analyses in blood samples of older adults (60-83 years old) with and without chronic pain to determine whether an epigenetic age biomarker is associated with the presence and burden of chronic pain. A subset of participants (n=29) in the NEPAL study underwent a blood draw, and completed demographic, psychological, and pain assessments, including quantitative sensory testing (n=29). We estimated Horvath's epigenetic clock and calculated the difference between epigenetic age and chronological age that has been previously reported to predict overall mortality risk. Older individuals without chronic pain (n=9) had significantly “younger” epigenetic age compared to those with chronic pain (n=20,p 0.05). Epigenetic age difference was not generally associated with demographic or psychological function (p's>0.05). Our findings suggest that chronic pain is associated with greater epigenetic aging in relatively healthy, community-dwelling older individuals and future studies with larger samples are needed to confirm our findings. An aging biomarker such as the epigenetic clock may help identify people with chronic pain at greater risk of functional decline and poorer health outcomes.

(339) Multisite Pain in Community-Dwelling Older Adults

Musculoskeletal pain is prominent in older individuals, with about half of the population reporting chronic pain in community settings. Generally, multisite pain is reported more often than single site pain in this population, but little research has focused on its associations with various pain, psychological and functional characteristics. Older adults (n = 87, female (n=55), mean age 72, SD=6.8, 63%) a part of the Neuromodulatory Examination of Pain and Mobility Across the Lifespan (NEPAL) study completed laboratory visits assessing clinical and experimental pain, as well as measures of psychological and physical function. We hypothesized that a greater number of anatomical pain sites in older individuals would be associated with worse pain, psychological and physical function. One-third of the sample (n=31, 35.6%) did not experience chronic pain while on average older individuals reporting chronic pain reported on average 4 anatomical pain sites (SD=2.7). Multiple hierarchical regression analyses suggested that an increasing number of anatomical pain sites was associated with greater clinical pain severity, increased experimental pressure pain sensitivity, lower positive affect, greater negative affect even after accounting for age, sex, education, and race as covariates (all p's

Epigenetic aging is associated with clinical and experimental pain in community-dwelling older adults.

Gerontological research reveals considerable interindividual variability in aging phenotypes, which has motivated research efforts to identify “aging biomarkers.” Aging biomarkers are used to calculate biological age, which are better predictors of disease risk and residual lifespan when compared to chronological age alone. Emerging evidence using the epigenetic clock as an aging biomarker supports highly reliable individualized predictions about future health. This study aimed to determine whether an epigenetic aging biomarker was associated with chronic pain in older adults (60–83 years old). A subset of participants (n = 29) in the Neuromodulatory Examination of Pain and Mobility Across the Lifespan study underwent a blood draw, demographic, psychological, cognitive, and pain assessments. We estimated Horvath’s epigenetic clock and calculated the difference between epigenetic age and chronological age that has been previously reported to predict overall mortality risk. Older individuals without chronic pain (n = 9) had significantly “younger” epigenetic age compared to those with chronic pain (n = 20, p < 0.05). Older epigenetic age was associated with greater pain during daily activities (r = 0.494, p = 0.010) and anatomical pain sites (r = 0.741, p < 0.001) but not pain frequency/duration. An older epigenetic age was also associated with higher vibratory detection thresholds (r = 0.490, p = 0.021), heat pain thresholds (r = −0.478, p = 0.028), and pressure pain thresholds at the trapezius (r = −0.571, p = 0.006) but not thermal detection, pressure pain at the quadriceps or pain inhibition (p’s > 0.05). Epigenetic aging was associated with greater emotional stability (r = −0.461, p = 0.027), conscientiousness (r = −0.549, p = 0.007), and lower extraversion (r = 0.414, p = 0.049) but not depression or affect (p’s > 0.05). Epigenetic aging was also associated with lower episodic (r = −0.698, p = 0.001) and working memory (r = −0.760, p < 0.001). Our findings suggest that chronic pain is associated with accelerated epigenetic aging in healthy, community-dwelling older individuals, and future studies with larger samples are needed to confirm our findings. An aging biomarker such as the epigenetic clock may help identify people with chronic pain at greater risk of functional decline and poorer health outcomes.

Effects of Exercise Training Combined with Increased Physical Activity to Prevent Chronic Pain in Community-Dwelling Older Adults: A Preliminary Randomized Controlled Trial.

Objective With the aim of developing a chronic pain prevention program, this randomized controlled trial examined whether exercise training combined with increased physical activity more effectively improves pain and physical activity than exercise training alone in community-dwelling older adults without chronic pain. Methods We randomized 76 older adults without chronic pain into an intervention group (n=38) involving exercise training combined with increased physical activity and a control group (n=38) involving exercise training alone. The exercise training comprised weekly 60-min sessions for 12 weeks. The program to increase physical activity required participants to record their daily step counts using pedometers. Pain intensity, total number of pain sites, and physical activity were assessed before and 12 weeks after the intervention. Results A time-by-group interaction was found for physical activity, with the intervention group showing significant improvement (p < 0.05). The intervention group also showed greater improvement in pain intensity and total number of pain sites at 12 weeks after intervention than the control group (p < 0.05). Conclusions In older adults without chronic pain, exercise training combind with increased physical activity improves key outcome indicators more effectively than exercise training alone. “This trial is registered with UMIN000018503.”