Paley Carole A, Johnson Mark I
*Airedale NHS Foundation Trust, West Yorkshire †Faculty of Health and Social Sciences, Leeds Beckett University ‡Leeds Pallium Research Group, Leeds, UK.
Clin J Pain. 2016 Apr;32(4):365-70. doi: 10.1097/AJP.0000000000000258.
The increasing prevalence of chronic pain and obesity has significant health and cost implications for economies in the developed and developing world. Evidence suggests that there is a positive correlation between obesity and chronic pain and the link between them is thought to be systemic inflammation.
The aim of this narrative review was to explore the physiological links between chronic musculoskeletal pain and obesity and to consider the potential role of regular physical activity in providing a means of managing obesity-related chronic pain.
Systemic inflammation, mechanical overload, and autonomic dysfunction are associated with increased prevalence and severity of chronic pain in individuals with obesity. It has been proposed, therefore, that interventions that target systemic inflammation could help to reduce chronic pain in obese individuals. Reduction in abdominal fat has been shown to alleviate pain and reduce the systemic markers of inflammation that contribute to chronic pain. Interventions that include exercise prescription have been shown to reduce both abdominal fat and systemic inflammation. Furthermore, exercise is also known to reduce pain perception and improve mental health and quality of life that also improves pain outcomes. However, adherence to formal exercise prescription is poor and therefore exercise programmes should be tailored to the interests, needs, and abilities of individuals to reduce attrition.
慢性疼痛和肥胖症患病率的不断上升,对发达国家和发展中国家的经济有着重大的健康和成本影响。有证据表明,肥胖与慢性疼痛之间存在正相关,且二者之间的联系被认为是全身性炎症。
本叙述性综述的目的是探讨慢性肌肉骨骼疼痛与肥胖之间的生理联系,并考虑定期体育活动在管理肥胖相关慢性疼痛方面的潜在作用。
全身性炎症、机械性超负荷和自主神经功能障碍与肥胖个体慢性疼痛的患病率和严重程度增加有关。因此,有人提出,针对全身性炎症的干预措施可能有助于减轻肥胖个体的慢性疼痛。腹部脂肪减少已被证明可减轻疼痛,并降低导致慢性疼痛的全身性炎症标志物水平。包括运动处方在内的干预措施已被证明可减少腹部脂肪和全身性炎症。此外,运动还能降低疼痛感知,改善心理健康和生活质量,进而改善疼痛状况。然而,对正规运动处方的依从性较差,因此运动计划应根据个人的兴趣、需求和能力进行调整,以减少退出率。