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Comparable conditioned pain modulation and painful-exercise-induced hypoalgesia in healthy young adults: A randomised crossover trial
Journal article   Open access   Peer reviewed

Comparable conditioned pain modulation and painful-exercise-induced hypoalgesia in healthy young adults: A randomised crossover trial

Di Ye, Peter Drummond and Dr Lechi Vo
The Journal of Pain, Vol.25(12), 104670
2024
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Abstract

Conditioned pain modulation and exercise-induced hypoalgesia reflect inhibitory pain controls emanating from the brain. The aim of this study was to compare the extent of pain inhibition from exercise-induced hypoalgesia (isometric wall squat), conditioned pain modulation (cold-water immersion), and their combination (wall squat followed by cold water in fixed order) in healthy pain-free adults. Sixty-one participants (median age 21 years) completed three sessions (Wall-squat, Cold-water, Combined) in random order. Sessions were separated by at least a week. In each session, pressure-pain thresholds, single-pinprick-pain ratings, and pinprick-temporal summation of pain (the fifth minus the first) were obtained at quadriceps, forearms, and forehead, before and after wall squat and/or cold water. Each intervention inhibited pain to pressure (partial η2 =.26) and single pinprick (partial η2 =.16) to a similar extent; however, pressure-pain inhibition was negligible in the forehead. After adjusting for age and sex, single-pinprick-pain inhibition in the forehead induced by wall squat was associated with that induced by cold water (adjusted R2 =.15; p =.007), and stronger pain inhibition was predicted by a higher thigh-pain rating to wall squat (adjusted R2 =.10; p =.027). Neither intervention affected pinprick-temporal summation of pain. Together, the findings suggest that pain inhibitory effects of exercise-induced hypoalgesia and conditioned pain modulation may overlap when exercise is at least moderately painful (6/10 intensity). Pressure-pain in body regions remote from the exercised or conditioned sites may be weakly modulated.

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