Evidence-Based Exercise Induced Hypoalgesia_Introduction



Pain is a complex experience, unique to each individual and difficult to define and treat. It is now considered the ''fifth vital sign'' and as it well-known that everyone we'll experience pain at some point of our lives, the Joint Commision on Accreditation of Healthcare Organizations mandates that effective pain management is appropriate for all patients.

As far as the of chronic pain (pain that exists more than 6 months after the initial injury) is concerned it affects up to 57% of general poplulation and has a significant impact on everyday quality of life interfing with work in 60% and recreational activities in 85% of individuals. The approach to the treatment of chronic pain should be inerdisciplinary and doctors should encourage their patients on activity modification and exercise while minimizing passive treatments.

Beside the high quality research the mechanisms of how exercise relieves pain are not clear yet and several areas need further study. However, it is clear that exercise prescription is a necessary and important component in the management of both the acute and chronic pain. Manual therapy and physical modalities should only be used as adjuncts to the active, exercise-oriented approach. 

Over the years, different types of exercises have been used to treat people with pain, including aerobic, strengthening strrethcing and range of motions exercise. Current Guidelines suggest that exercise recommendations should be individualized and take into account the pain condition along with the type of exercise and the lifestyle of the patient. Experts suggest that it seems possible that future research could lead to a protocol in which exercise is prescribed to prevent the development of pain.

Although it has been taken a very long time to understant what Emily Dickinson meant when she wrote about pain in 1920s, the exponential growth in research that can be used by the clinician seems quite promising for the development of a patient targeted effective plan of care.

References: Sluka K.A. (2009). Mechanisms and Management of Pain for the Physical Therapist. USA: IASP Press.


Pain has an element of blank; It cannot recollect. It has no future but itself. Dickinson E. 1924


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