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. 2023 May 24;18(5):e0285041.
doi: 10.1371/journal.pone.0285041. eCollection 2023.

Longitudinal relationships between habitual physical activity and pain tolerance in the general population

Anders Pedersen Årnes  1 , Christopher Sievert Nielsen  2   3 , Audun Stubhaug  3   4 , Mats Kirkeby Fjeld  2 , Aslak Johansen  1 , Bente Morseth  5 , Bjørn Heine Strand  2   6 , Tom Wilsgaard  7 , Ólöf Anna Steingrímsdóttir  2
Affiliations

Longitudinal relationships between habitual physical activity and pain tolerance in the general population

Anders Pedersen Årnes et al. PLoS One. .

Abstract

Physical activity (PA) might influence the risk or progression of chronic pain through pain tolerance. Hence, we aimed to assess whether habitual leisure-time PA level and PA change affects pain tolerance longitudinally in the population. Our sample (n = 10,732; 51% women) was gathered from the sixth (Tromsø6, 2007-08) and seventh (Tromsø7, 2015-16) waves of the prospective population-based Tromsø Study, Norway. Level of leisure-time PA (sedentary, light, moderate, or vigorous) was derived from questionnaires; experimental pain tolerance was measured by the cold-pressor test (CPT). We used ordinary, and multiple-adjusted mixed, Tobit regression to assess 1) the effect of longitudinal PA change on CPT tolerance at follow-up, and 2) whether a change in pain tolerance over time varied with level of LTPA. We found that participants with high consistent PA levels over the two surveys (Tromsø6 and Tromsø7) had significantly higher tolerance than those staying sedentary (20.4 s. (95% CI: 13.7, 27.1)). Repeated measurements show that light (6.7 s. (CI 3.4, 10.0)), moderate (CI 14.1 s. (9.9, 18.3)), and vigorous (16.3 s. (CI 6.0, 26.5)) PA groups had higher pain tolerance than sedentary, with non-significant interaction showed slightly falling effects of PA over time. In conclusion, being physically active at either of two time points measured 7-8 years apart was associated with higher pain tolerance compared to being sedentary at both time-points. Pain tolerance increased with higher total activity levels, and more for those who increased their activity level during follow-up. This indicates that not only total PA amount matters but also the direction of change. PA did not significantly moderate pain tolerance change over time, though estimates suggested a slightly falling effect possibly due to ageing. These results support increased PA levels as a possible non-pharmacological pathway towards reducing or preventing chronic pain.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow of study participants.
a Linear Tobit regression; n missing covariates = 256. b Mixed model Tobit regression; missing on covariates = 478. LTPA = leisure-time physical activity; CPT = cold-pressor test.
Fig 2
Fig 2. Relationship between groups of physical activity change from Tromsø6 to Tromsø7 and seconds of cold pain tolerance.
Ordered by effect size. PA = physical activity; CI = confidence interval.
Fig 3
Fig 3. Withdrawals from the cold-pressor test according to leisure-time physical activity groups.
Tromsø6 and Tromsø7. CPT = cold-pressor test; LTPA = leisure-time physical activity (6 or 7 for respective Tromsø Study survey).
See this image and copyright information in PMC

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Grants and funding

APÅ was funded by a grant from the Northern Norway Regional Health Authority (grant number HNF1352-17). www.helse-nord.no. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.