Effects of a single exercise session on pain intensity in adults with chronic pain: a systematic review and meta-analysis

• Published in: Musculoskeletal science & practice Vol. 62; p. 102679
• Main Authors: Shah, Brishna, Wewege, Michael A., Gilanyi, Yannick L., Clifford, Briana K., Devonshire, Jack J., McAuley, James H., Jones, Matthew D.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-12-2022
• Subjects: Adult; Analgesia; Chronic pain; Chronic Pain - therapy; Exercise; Female; Humans; Male; Meta-analysis; Musculoskeletal pain; Pain Measurement; Randomized Controlled Trials as Topic; Analgesia; Musculoskeletal pain; Exercise; Chronic pain; Meta-analysis
• ISSN: 2468-7812; 2468-7812
• DOI: 10.1016/j.msksp.2022.102679

Chronic pain is prevalent amongst society, making it necessary to find strategies to manage chronic pain. Regular exercise is efficacious; however, pain is a barrier to initiating exercise. A single exercise session is also believed to acutely reduce pain, however, the evidence for this is less robust.
This systematic review and meta-analysis aimed to identify the effect of a single exercise session on pain intensity in adults with chronic pain.
We searched eight databases and trial registries to identify randomised controlled trials evaluating the effect of a single exercise session on pain intensity in adults with chronic pain compared to a non-exercise control. Literature screening, data extraction, risk of bias (Cochrane 2.0) and quality assessment (GRADE) were conducted independently and in duplicate. Random-effects meta-analyses were performed using the metafor package in R.
We included 17 trials (46 study arms with 664 adults [44% female]). There were no significant differences in pain intensity (mean difference on a 0-10 scale) immediately post-exercise −0.02 (95% CI = −0.06, 0.62; I2 = 77.1%) or up to 45-min post-exercise −0.17 (95% CI = −0.49, 0.16; I2 = 34.2%). All trials were at high risk of bias and the overall confidence in these findings was very low.
A single exercise session did not reduce pain intensity up to 1-h post-exercise. Notably, increases in pain were not observed either, suggesting that while pain can be a barrier to initiating exercise, clinicians can educate patients on the unlikelihood of exercise acutely increasing pain intensity.
•A single exercise session does not appear to affect pain intensity.•Clinicians can educate clients on the unlikelihood of exercise increasing pain.•These findings are based on very low quality evidence.•Further research with studies using better designs is needed.