Exercise is the most effective modifiable health behavior recommended for preventing and reversing all-cause mortality, improving mental health, and reducing or preventing chronic pain. Exercise is among the least harmful modalities available to treat pain, yet people with persistent pain often do not have the motivation, physical capacity, or willingness to engage in it secondary to allostatic overload. Patients experiencing chronic pain often present with concomitant psychopathologies, medical comorbidities, and maladaptive coping strategies leading to low tolerance thresholds for physical and nonphysical stressors. The evidence for specific mechanisms underpinning exercise effects is mixed. The efficacy of exercise as an intervention likely results from a combination of specific physiologic effects and contextual factors that impact psychological attitudes and coping behaviors. In this presentation, we will review 8 key points regarding utilization and implementation of exercise to treat pain and its influence on the biopsychosocial determinants of pain.
Define the concept of allostatic loading and its influence on pain and exercise
Recite minimal effective dosing, and optimal dosing, of cardiovascular and resistance exercise to maximize systemic health effects
Differentiate the dosing ranges to facilitate analgesic effects of resistance (isometric and dynamic) and aerobic exercise for pain free and chronic pain population
Recognize how to leverage contextual factors (meaning response) associated with exercise prescription to maximize analgesic and systemic health effects