Núñez-Cortés Rodrigo, Salazar-Méndez Joaquín, Nijs Jo
Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago 8240000, Chile.
Escuela de Ciencias del Deporte y Actividad Física, Facultad de Salud, Universidad Santo Tomás, Talca 3460000, Chile.
J Funct Morphol Kinesiol. 2025 May 20;10(2):183. doi: 10.3390/jfmk10020183.
: This narrative review aims to analyze physical activity as a central pillar of lifestyle modification in the management of chronic musculoskeletal pain by examining its effects on pain modulation as well as related lifestyle domains, including sleep, stress regulation, dietary habits, and smoking behavior. : A narrative structured review was conducted. We searched MEDLINE/PubMed, Embase, and Cochrane Reviews using terms related to chronic pain and lifestyle. Randomized controlled trials, observational studies, systematic reviews, and narrative reviews reporting on the concepts of interest were included. The results were synthesized and described narratively. : Through the release of neuromodulatory compounds such as endorphins, endocannabinoids, dopamine, and serotonin, exercise improves analgesia, promotes emotional resilience, and reduces the reward response associated with addictive behaviors such as smoking. Its effects on the hypothalamic-pituitary-adrenal axis reduce cortisol levels, while melatonin regulation promotes circadian synchronization and deeper sleep stages. In addition, exercise modulates appetite by increasing insulin sensitivity and altering hormones such as leptin and ghrelin, contributing to appetite control and energy balance. These mechanisms support a comprehensive approach to chronic pain management. : Physical activity is a core component of lifestyle-based chronic pain management, not only because of its analgesic effects, but also because of its positive influence on sleep, stress regulation, dietary habits, and smoking reduction. Although the available evidence is promising, more randomized controlled trials are needed to examine the effects of exercise on other healthy lifestyle behaviors, such as stress reduction, dietary modification, and smoking cessation, to consolidate its role in the comprehensive prevention and management of chronic pain.
本叙述性综述旨在通过研究体育活动对疼痛调节以及相关生活方式领域（包括睡眠、压力调节、饮食习惯和吸烟行为）的影响，分析其作为慢性肌肉骨骼疼痛管理中生活方式改变的核心支柱的作用。
进行了一项叙述性结构综述。我们使用与慢性疼痛和生活方式相关的术语在MEDLINE/PubMed、Embase和Cochrane综述中进行检索。纳入了报告感兴趣概念的随机对照试验、观察性研究、系统综述和叙述性综述。结果进行了综合并以叙述方式描述。
通过释放内啡肽、内源性大麻素、多巴胺和血清素等神经调节化合物，运动改善镇痛效果，促进情绪恢复力，并减少与吸烟等成瘾行为相关的奖赏反应。其对下丘脑 - 垂体 - 肾上腺轴的影响降低了皮质醇水平，而褪黑素调节促进昼夜节律同步和更深的睡眠阶段。此外，运动通过增加胰岛素敏感性和改变瘦素和胃饥饿素等激素来调节食欲，有助于控制食欲和能量平衡。这些机制支持了慢性疼痛管理的综合方法。
体育活动是基于生活方式的慢性疼痛管理的核心组成部分，不仅因为其镇痛作用，还因为其对睡眠、压力调节、饮食习惯和减少吸烟的积极影响。尽管现有证据很有前景，但仍需要更多的随机对照试验来研究运动对其他健康生活方式行为（如减轻压力、饮食调整和戒烟）的影响，以巩固其在慢性疼痛综合预防和管理中的作用。
