School of Psychology and Centre for Healthy Ageing, College of Health and Education, Murdoch University, Murdoch, Western Australia, Australia.
School of Psychology and Centre for Healthy Ageing, College of Health and Education, Murdoch University, Murdoch, Western Australia, Australia.
J Pain. 2024 Dec;25(12):104670. doi: 10.1016/j.jpain.2024.104670. Epub 2024 Sep 6.
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 3 sessions (wall-squat, cold-water, and 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 η = .26) and single pinprick (partial η = .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 R = .15; P = .007), and stronger pain inhibition was predicted by a higher thigh-pain rating to wall squat (adjusted R = .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. PERSPECTIVE: The current findings suggest that pain-inhibitory effects induced by painful wall squat and by cold-water immersion may overlap. The magnitude of pain inhibition in the forehead remote from the exercised thigh or the conditioned foot appears smaller, which could be examined further in future research.
条件性疼痛调制和运动引起的痛觉减退反映了来自大脑的抑制性疼痛控制。本研究的目的是比较运动引起的痛觉减退（等长靠墙深蹲）、条件性疼痛调制（冷水浸泡）和它们的组合（按固定顺序先靠墙深蹲后冷水浸泡）在健康无痛成年人中的疼痛抑制程度。61 名参与者（中位数年龄 21 岁）以随机顺序完成了 3 次（靠墙深蹲、冷水浸泡和组合）测试。每次测试之间至少间隔一周。在每次测试中，在股四头肌、前臂和前额测量压力疼痛阈值、单次刺痛疼痛评分和刺痛时间总和（第五次减去第一次），在靠墙深蹲和/或冷水浸泡前后。每种干预措施都以相似的程度抑制了压力（部分η=0.26）和单次刺痛（部分η=0.16）的疼痛；然而，前额的压力疼痛抑制可以忽略不计。在调整年龄和性别后，靠墙深蹲引起的前额单次刺痛疼痛抑制与冷水浸泡引起的前额单次刺痛疼痛抑制相关（调整 R=0.15；P=0.007），并且靠墙深蹲时大腿疼痛评分越高，疼痛抑制越强（调整 R=0.10；P=0.027）。两种干预措施都不影响刺痛时间总和的疼痛。总的来说，这些发现表明，当运动至少是中度疼痛（6/10 强度）时，运动引起的痛觉减退和条件性疼痛调制的疼痛抑制作用可能会重叠。远离运动或条件化部位的身体区域的压力疼痛可能会受到较弱的调节。观点：目前的研究结果表明，由疼痛的靠墙深蹲和冷水浸泡引起的疼痛抑制作用可能会重叠。远离运动大腿或条件化足部的前额的疼痛抑制程度较小，这可以在未来的研究中进一步研究。
