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Does exercise increase or decrease pain? Central mechanisms underlying these two phenomena
Lucas V Lima1, Thiago S S Abner1, Kathleen A Sluka1
1Department of Physical Therapy and Rehabilitation Science, Pain Research Program, University of Iowa, Iowa City, IA, 52242, USA.
The Journal of Physiology
|April 4, 2017
Summary
Exercise can both cause and relieve chronic pain by affecting central nervous system pathways. Understanding these mechanisms is key for effective pain management and rehabilitation strategies.
Area of Science:
- Neuroscience
- Pain Management
- Rehabilitation Science
Background:
- Exercise is crucial for chronic musculoskeletal pain rehabilitation.
- Physical activity effectively treats chronic pain but can paradoxically increase it.
- Central mechanisms for exercise-induced pain and analgesia are not fully understood.
Purpose of the Study:
- To review current evidence on central mechanisms of exercise-induced pain.
- To discuss central mechanisms of exercise-induced analgesia.
- To explore the role of specific neurotransmitter systems in exercise and pain.
Main Methods:
- Review of animal models of exercise-induced pain.
- Analysis of basic science studies on exercise protocols and pain.
- Examination of central nervous system pathways involved in pain modulation.
Main Results:
- Animal models suggest central mechanisms like NMDA receptor activation contribute to exercise-induced pain.
- Exercise-induced analgesia involves the activation of central inhibitory pathways.
- Opioid, serotonin, and NMDA mechanisms in the rostral ventromedial medulla are implicated in exercise-associated analgesia.
Conclusions:
- Exercise's dual role in pain (induction and relief) is mediated by complex central mechanisms.
- Understanding these central pathways is vital for optimizing exercise in pain rehabilitation.
- Further research into opioid, serotonin, and NMDA receptor functions can inform therapeutic strategies.