Medical College of Wisconsin
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Update on the relation between pain and movement: consequences for clinical practice. Clin J Pain 2010;26(9):754-62

Date

07/29/2010

Pubmed ID

20664335

DOI

10.1097/AJP.0b013e3181e0174f

Scopus ID

2-s2.0-77958449750 (requires institutional sign-in at Scopus site)   54 Citations

Abstract

It is generally thought that exercise is beneficial to alleviate pain. However, prolonged movement may lead to the development of painful injuries, because of the overload of low-threshold motor units. Especially in individuals with a pain condition, exercise prescription and the impact of fatigue is less clear. This may be because of the dual effects, aggravation and relief, which fatigue has on pain. The purpose of this review is to ascertain the relation between pain and the motor system, both in the development and management of pain. Recent studies show that fatigue alters pain-induced increases in corticomotor excitability and leads to within and between-muscle adaptations. Studies of acute pain have shown complex adaptations such as increased movement variability, which may be because of a search for motor solutions to prolong overall task performance. In contrast, chronic pain seems to limit movement duration, speed, and variability which could be protective in the short term but also counterproductive over time. Owing to these adaptations in movement strategies, pain chronicity may help to dictate exercise prescription. For example, the correct dosage of multimuscle, dynamic exercises would act to promote movement variability. Thus, it seems that exercise involving the use of different movement strategies could be effective in helping people to obtain exercise-induced benefits while avoiding injury and pain reaggravation.

Author List

Cote JN, Hoeger Bement MK

Author

Marie Hoeger Bement MPT,PhD Associate Professor in the Physical Therapy department at Marquette University




MESH terms used to index this publication - Major topics in bold

Adaptation, Physiological
Exercise Therapy
Humans
Movement
Musculoskeletal Diseases
Pain
Pain Management