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Impaired exercise‐induced hypoalgesia in individuals reporting an increase in low back pain during acute exercise
Author(s) -
Vaegter Henrik B.,
Petersen Kristian K.,
Sjodsholm Line V.,
Schou Pia,
Andersen Michael B.,
GravenNielsen Thomas
Publication year - 2021
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.1726
Subject(s) - hypoalgesia , medicine , physical therapy , low back pain , summation , threshold of pain , back pain , visual analogue scale , physical medicine and rehabilitation , hyperalgesia , nociception , receptor , alternative medicine , pathology , stimulation
Objectives Exercise therapy is recommended for low back pain (LBP) although the immediate effects on pain are highly variable. In 96 individuals with LBP this cross‐sectional study explored (a) the magnitude of exercise‐induced hypoalgesia (EIH) and (b) measures of pain sensitivity and clinical pain manifestations in individuals reporting a clinical relevant increase in back pain during physical activity compared with individuals reporting low or no increase in back pain during physical activity. Methods Cuff algometry was performed at baseline on the leg to assess pressure pain threshold (cPPT), tolerance (cPTT) and temporal summation of pain (cTSP). Manual PPTs were assessed on the back and leg before and after a 6‐min walk test (6MWT). Back pain was scored on a numerical rating scale (NRS) after each minute of walking. The EIH‐effect was estimated as the increase in PPTs after the walk exercise. Results Twenty‐seven individuals reported an increase of ≥2/10 in pain NRS scores during walking and compared with the individuals with <2/10 NRS scores: cPPT and EIH‐effects were lower whereas cTSP, pain intensity and disability were increased ( p < 0.03). Baseline NRS scores, EIH and pain thresholds were associated with the likelihood of an increase of ≥2/10 in back pain intensity during walking ( p < 0.05). Conclusions Pain flares in response to physical activity in individuals with LBP seem to be linked with baseline pain sensitivity and pain intensity, and impair the beneficial EIH. Such information may better inform when individuals with LBP will have a beneficial effect of physical activity. Significance Pain flares in response to physical activity in individuals with LBP seem to be linked with baseline pain sensitivity and pain intensity, and impair the beneficial exercise‐induced hypoalgesia. Such information may better inform when individuals with LBP will have a beneficial effect of physical activity.