Exercise and Activity in Pain Management: Difference between revisions
No edit summary |
No edit summary |
||
| Line 21: | Line 21: | ||
= EXERCISE INDUCED HYPOALGESIA (EIH) = | = EXERCISE INDUCED HYPOALGESIA (EIH) = | ||
EIH is phenomenon which has been extensively studied in the literature, and results of which are ambiguous. EIH is poorly understood, and it is characterized secondary to increase in pain threshold and tolerance in addition to reduction of pain intensity rating during and after exercise<ref name="6">Koltyn KF, Brellenthin AG, Cook DB, Sehgal N, Hillard C. Mechanisms of exercise-induced hypoalgesia. The Journal of Pain. 2014 Dec 31;15(12):1294-304.</ref>. | EIH is phenomenon which has been extensively studied in the literature, and results of which are ambiguous. EIH is poorly understood, and it is characterized secondary to increase in pain threshold and tolerance in addition to reduction of pain intensity rating during and after exercise<ref name="6">Koltyn KF, Brellenthin AG, Cook DB, Sehgal N, Hillard C. Mechanisms of exercise-induced hypoalgesia. The Journal of Pain. 2014 Dec 31;15(12):1294-304.</ref>. | ||
Most commonly accepted hypothesis behind EIH states that central opioid systems are activated by increased discharges from mechanosensitive afferent nerve fibers A-delta and IV (C) arising from skeletal muscles secondary to rhythmic muscle contraction<ref name="7">Thorén P, Floras JS, Hoffmann P, Seals DR. Endorphins and exercise: physiological mechanisms and clinical implications. Medicine &amp; science in sports &amp; exercise. 1990 Aug. 22(4): 417-428</ref><ref name="8">Koltyn KF, Brellenthin AG, Cook DB, Sehgal N, Hillard C. Mechanisms of exercise-induced hypoalgesia. The Journal of Pain. 2014 Dec 31;15(12):1294-304.</ref>. Exercise has also shown increase in blood beta-endorphin concentrations in men<ref name="7" />. | |||
Another proposed mechanism for EIH is Endocannabinoids<ref name="10">Dietrich A &amp; McDaniel WF. Endocannabinoids and exercise. Br J Sports Med 2004;38:536–541</ref>. Exercise increases serum concentrations of endocannabinoids which may contribute to control of pain transmission. Koltyn et al<ref name="8" /> suggested involvement of non-opioid mechanism in EIH following isometric exercise. Given this two mechanisms for EIH, the exact mechanism remains unknown. <br><br> | |||
Another proposed mechanism for EIH is Endocannabinoids<ref name="10">Dietrich A & McDaniel WF. Endocannabinoids and exercise. Br J Sports Med 2004;38:536–541</ref>. Exercise increases serum concentrations of endocannabinoids which may contribute to control of pain transmission. Koltyn et al<ref name="8" /> suggested involvement of non-opioid mechanism in EIH following isometric exercise. Given this two mechanisms for EIH, the exact mechanism remains unknown. <br><br> | |||
== Sub Heading 3<br> == | == Sub Heading 3<br> == | ||
Revision as of 04:54, 14 March 2016
- Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!
- If you would like to get involved in this project and earn accreditation for your contributions, please get in touch!
Tips for writing this page:
- Decribe the principles of exercise prescription and review the evidence about how these might need to be modified to for use in clinical practie for a pateint in pain - reps/sets/duration/intensity/pacing/goal setting/motivation.
- Review the current evidence based for exercise prescription to manage a pain experince. What are the underlying physiological process at work here?
- Are there any models/theories relating to exercise prescription for managing acute/chronic pain?
Original Editor - Add a link to your Physiopedia profile here.
Top Contributors - Vinit Kothekar, Jess Bell, Kim Jackson, Admin, Michelle Lee, Nupur Smit Shah, Simisola Ajeyalemi, Lucinda hampton, 127.0.0.1, Evan Thomas, Jo Etherton, Vidya Acharya, Rucha Gadgil, Lauren Lopez, Carin Hunter, Yigit Unalan, Wendy Walker and WikiSysop
Introduction[edit | edit source]
As defined by International Association for Study of Pain (IASP), pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” It further states that “pain is always subjective, and each individual learns the application of the word through experiences related to injury in early life.” IASP also argues that activity induced in nociceptor and nociceptive pathways by noxious stimulus is not pain.
For people suffering from pain, their initial response is to avoid activity and seek rest. And yet exercise therapy is often prescribed as a treatment option to manage pain. There are known benefits of exercise and regular physical activity. CDC lists following as the benefits of physical activity: controls weight, reduces risk of cardiovascular disease and metabolic disease, reduces risk of some cancers, strengthens bones and muscles, improves mental health and mood, improves ability to perform daily activities and prevent falls, and increases chances of living longer. Exercises and physical activity not only have benefits in healthy individual but also has proven benefits in patients. Considering this some authors have postulated an idea that exercise should be considered as a drugCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. And often most important benefit of exercise for patients is improved pain controlCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
EXERCISE INDUCED HYPOALGESIA (EIH)[edit | edit source]
EIH is phenomenon which has been extensively studied in the literature, and results of which are ambiguous. EIH is poorly understood, and it is characterized secondary to increase in pain threshold and tolerance in addition to reduction of pain intensity rating during and after exerciseCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
Most commonly accepted hypothesis behind EIH states that central opioid systems are activated by increased discharges from mechanosensitive afferent nerve fibers A-delta and IV (C) arising from skeletal muscles secondary to rhythmic muscle contractionCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. Exercise has also shown increase in blood beta-endorphin concentrations in menCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title.
Another proposed mechanism for EIH is EndocannabinoidsCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. Exercise increases serum concentrations of endocannabinoids which may contribute to control of pain transmission. Koltyn et alCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title suggested involvement of non-opioid mechanism in EIH following isometric exercise. Given this two mechanisms for EIH, the exact mechanism remains unknown.
Sub Heading 3
[edit | edit source]
Add text here...
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
When prescribing exercise for pain amnagement it is important that we:
- Understand the parameters (i.e., mode, frequency, duration, intensity) of therapeutic exercise for pain relief.
- Describe how to modify exercise parameters as they relate to the pain condition, age, psychosocial factors, and patient's health status.
- Recognize the importance of implementing adjunct therapies to address issues related to exercise prescription (i.e., biopsychosocial, fear avoidance behaviour, catastrophizing, cognitive behavioural therapy).
- Understand the importance of patient education in prescribing therapeutic exercise, including the concept of motivation, pacing) to enhance overall treatment effectiveness and compliance.
