Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Pain. 2023 Apr 1;164(4):838-847. doi: 10.1097/j.pain.0000000000002773. Epub 2022 Sep 8.
Epidemiological literature on the relationship between physical activity and chronic pain is scarce and inconsistent. Hence, our aim was to assess the relationship applying comprehensive methodology, including self-reported and accelerometer measures of physical activity and different severity levels of chronic pain. We used data from the Tromsø Study (2015-2016). All residents in the municipality, aged 40 years and older were invited to participate (n = 32,591, 51% women). A total of 21,083 (53%) women reported on questionnaires. Additionally, 6778 participants (54% women) were invited to wear accelerometers (6125 with complete measurements). Our exposure measures were self-reported leisure time physical activity, exercise frequency, duration, and intensity and 2 accelerometer measures (steps per day and minutes of moderate to vigorous physical activity per day). Outcome measurements were chronic pain and moderate-to-severe chronic pain. We used Poisson regression to estimate chronic pain prevalence and prevalence ratios for each physical activity measure, with adjustments for sex, age, education level, smoking history, and occupational physical activity. Our main analyses showed an inverse dose-response relationship between all physical activity measures and both severity measures of chronic pain, except that the dose-response relationship with exercise duration was only found for moderate-to-severe pain. All findings were stronger for the moderate-to-severe pain outcomes than for chronic pain. Robustness analyses gave similar results as the main analyses. We conclude that an inverse dose-response association between physical activity and chronic pain is consistent across measures. To summarize, higher levels of physical activity is associated with less chronic pain and moderate-to-severe chronic pain.
体力活动与慢性疼痛之间的关系的流行病学文献很少且不一致。因此，我们的目的是应用综合方法评估这种关系，包括体力活动的自我报告和加速度计测量以及不同严重程度的慢性疼痛。我们使用特罗姆瑟研究（2015-2016 年）的数据。邀请该市所有 40 岁及以上的居民参加（n=32591，女性占 51%）。共有 21083 名（53%）女性在问卷上报告了情况。此外，还邀请了 6778 名参与者（女性占 54%）佩戴加速度计（54%有完整的测量值）。我们的暴露测量指标是自我报告的休闲时间体力活动、运动频率、时长和强度以及 2 个加速度计测量指标（每天的步数和每天中等到剧烈体力活动的分钟数）。结局测量指标是慢性疼痛和中重度慢性疼痛。我们使用泊松回归来估计每种体力活动指标的慢性疼痛患病率和患病率比，同时调整性别、年龄、教育水平、吸烟史和职业体力活动。我们的主要分析表明，除了运动持续时间与中重度疼痛之间仅存在剂量反应关系外，所有体力活动指标与慢性疼痛的两种严重程度指标之间均存在负相关关系。与慢性疼痛相比，所有发现对于中重度疼痛结果都更强。稳健性分析给出了与主要分析相似的结果。我们的结论是，体力活动与慢性疼痛之间的反比剂量反应关系在各种指标中是一致的。总之，较高水平的体力活动与较少的慢性疼痛和中重度慢性疼痛相关。
