Explicit Education About Exercise-Induced Hypoalgesia Influences Pain Responses to Acute Exercise in Healthy Adults: A Randomized Controlled Trial

J Pain. 2017 Nov;18(11):1409-1416. doi: 10.1016/j.jpain.2017.07.006. Epub 2017 Aug 1.


The mechanisms through which acute exercise reduces pain (ie, exercise-induced hypoalgesia [EIH]) are poorly understood. This study aimed to determine if education about EIH affected pain responses after acute exercise in healthy adults. Participants received 15 minutes of education either about EIH (intervention, n = 20) or more general education about exercise and pain (control, n = 20). After this, the participants' knowledge and beliefs about exercise and pain were assessed. Pressure pain thresholds were then measured before and after 20 minutes of cycle ergometer exercise. Compared with the control group, the intervention group believed more strongly that pain could be reduced by a single session of exercise (P = .005) and that the information they had just received had changed what they thought about the effect of exercise on pain (P = .045). After exercise, pressure pain threshold increased in both groups, but the median increase was greater in the intervention group compared with the control group (intervention = .78 kg/cm2, control = .24 kg/cm2, P = .002, effect size [r] of difference = .49). These results suggest that cognitive processes in the appraisal of pain can be manipulated to influence EIH in healthy adults.

Perspective: This study shows that preceding a bout of exercise with pain education can alter pain responses after exercise. This finding has potential clinical implications for exercise prescription for people with chronic pain whereby pain education before exercise could be used to improve pain responses to that exercise.

Keywords: Pain threshold; education; exercise; hypoalgesia; pain appraisal.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Exercise / physiology
  • Exercise / psychology*
  • Female
  • Health Education*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Learning
  • Male
  • Pain Perception* / physiology
  • Pain Threshold / physiology
  • Pain Threshold / psychology*
  • Pressure
  • Surveys and Questionnaires
  • Young Adult

Associated data

  • ANZCTR/ANZCTR12616001141437