The Role of Vigorous Exercise in Protection Against Pain

Athletes have been found to possess higher pain tolerance than the normal population.  The pain tolerance has been also found to be affected by psychological and psychosocial factors.  Athletes develop pain-coping skills and participation in regular vigorous exercise may improve the individual’s ability to cope with pain. 

Athletes have been found to display lower levels of pain-related fear and perceived mental stress during pain testing.  It is not clear whether high performance athletes, such as triathletes, have inherent or acquired qualities or perhaps acquired abilities from constant engagement in extreme physical and emotional efforts. 

Athletes are observed to willingly and enthusiastically expose themselves to painful situations and the outcome of exposure to pain is different with the higher level athlete. 

The random public with chronic pain often suffers distress in response to painful episodes, where athletes often find their pain exposures healthy, fulfilling, and satisfying.   

The question remains if normally active individuals can gain pain tolerance and coping abilities through athletic training.  The variable here is the innate pain tolerance and the acquired pain tolerance through athletic participation. 

It has been recognized that regular exercise may facilitate the release of endogenous opioids in the brain and central nervous system, reducing pain sensitivity and providing a “runner’s high.” 

The research on this subject needs to further clarify this issue.  At this point, however, activity, exercise, and higher level workouts or training has been demonstrated to be helpful in the patient with a susceptibility to recurrent painful episodes or in the individual suffering from chronic pain. 

Acknowledgment is given to The Back Letter, Volume 28, Number 12, December 13, pages 136 and 137; N. Geva and R. Defrin, Pain 2013;J.L. Rhudy, Pain 2013; and J. Tesarz, Pain 2012.

Editor’s Commentary: The late Robin McKenzie stated at the American Back Society meeting, 1987, Anaheim, California, that in the 21st century, the prime treatment for back pain will be movement.  At this point in time, all of the recent research-based clinical guidelines recommend movement, activity, and exercise as the primary and best overall treatment for back pain in the absence of red flag conditions. 

Conditioning, weight control, absence of the use of harmful or toxic substances, reasonable sleep habits, and a reasonably positive outlook can be and frequently are an effective method of treating, controlling, and also preventing back pain.  A common sense approach is critical in the treatment of back pain.

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