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Endogenous pain modulation in response to exercise in patients with rheumatoid arthritis, patients with chronic fatigue syndrome and comorbid fibromyalgia and healthy controls: a double blinded randomized controlled trial

(2015) PAIN PRACTICE. 15(2). p.98-106
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Abstract
Objective: Temporal summation (TS) of pain, conditioned pain modulation (CPM), and exercise-induced analgesia (EIA) are often investigated in chronic pain populations as an indicator for enhanced pain facilitation and impaired endogenous pain inhibition, respectively, but interactions are not yet clear both in healthy controls and in chronic pain patients. Therefore, the present double-blind randomized placebo-controlled study evaluates pains cores, TS, and CPM in response to exercise in healthy controls, patients with chronic fatigue syndrome and comorbid fibromyalgia (CFS/FM), and patients with rheumatoid arthritis (RA), both under placebo and paracetamol condition. Methods: Fifty-three female volunteers - of which 19 patients with CFS/FM, 16 patients with RA, and 18 healthy controls - underwent a submaximal exercise test on a bicycle ergometer on 2 different occasions (paracetamol vs. placebo), with an interval of 7days. Before and after exercise, participants rated pain intensity during TS and CPM. Results: Patients with rheumatoid arthritis showed decreased TS after exercise, both after paracetamol and placebo (P<0.05). In patients with CFS/FM, results were less univocal. A nonsignificant decrease in TS was only observed after taking paracetamol. CPM responses to exercise are inconclusive, but seem to worsen after exercise. No adverse effects were seen. Conclusion: This study evaluates pain scores, TS, and CPM in response to submaximal exercise in 2 different chronic pain populations and healthy controls. In patients with RA, exercise had positive effects on TS, suggesting normal EIA. In patients with CFS/FM, these positive effects were only observed after paracetamol and results were inconsistent.
Keywords
conditioned pain modulation, exercise-induced analgesia, temporal summation, acetaminophen, randomized controlled trial, NOXIOUS INHIBITORY CONTROL, TEMPORAL SUMMATION, 2ND PAIN, ACETAMINOPHEN, DEFINITION, ANALGESIA, THERAPY, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome, pain inhibition, sensitization

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Citation

Please use this url to cite or link to this publication:

Chicago
Meeus, Mira, Linda Hermans, Kelly Ickmans, Filip Struyf, Deborah Van Cauwenbergh, Laura Bronckaerts, Luc De Clerck, et al. 2015. “Endogenous Pain Modulation in Response to Exercise in Patients with Rheumatoid Arthritis, Patients with Chronic Fatigue Syndrome and Comorbid Fibromyalgia and Healthy Controls: a Double Blinded Randomized Controlled Trial.” Pain Practice 15 (2): 98–106.
APA
Meeus, M., Hermans, L., Ickmans, K., Struyf, F., Van Cauwenbergh, D., Bronckaerts, L., De Clerck, L., et al. (2015). Endogenous pain modulation in response to exercise in patients with rheumatoid arthritis, patients with chronic fatigue syndrome and comorbid fibromyalgia and healthy controls: a double blinded randomized controlled trial. PAIN PRACTICE, 15(2), 98–106.
Vancouver
1.
Meeus M, Hermans L, Ickmans K, Struyf F, Van Cauwenbergh D, Bronckaerts L, et al. Endogenous pain modulation in response to exercise in patients with rheumatoid arthritis, patients with chronic fatigue syndrome and comorbid fibromyalgia and healthy controls: a double blinded randomized controlled trial. PAIN PRACTICE. 2015;15(2):98–106.
MLA
Meeus, Mira, Linda Hermans, Kelly Ickmans, et al. “Endogenous Pain Modulation in Response to Exercise in Patients with Rheumatoid Arthritis, Patients with Chronic Fatigue Syndrome and Comorbid Fibromyalgia and Healthy Controls: a Double Blinded Randomized Controlled Trial.” PAIN PRACTICE 15.2 (2015): 98–106. Print.
@article{5838604,
  abstract     = {Objective: Temporal summation (TS) of pain, conditioned pain modulation (CPM), and exercise-induced analgesia (EIA) are often investigated in chronic pain populations as an indicator for enhanced pain facilitation and impaired endogenous pain inhibition, respectively, but interactions are not yet clear both in healthy controls and in chronic pain patients. Therefore, the present double-blind randomized placebo-controlled study evaluates pains cores, TS, and CPM in response to exercise in healthy controls, patients with chronic fatigue syndrome and comorbid fibromyalgia (CFS/FM), and patients with rheumatoid arthritis (RA), both under placebo and paracetamol condition. 
Methods: Fifty-three female volunteers - of which 19 patients with CFS/FM, 16 patients with RA, and 18 healthy controls - underwent a submaximal exercise test on a bicycle ergometer on 2 different occasions (paracetamol vs. placebo), with an interval of 7days. Before and after exercise, participants rated pain intensity during TS and CPM. 
Results: Patients with rheumatoid arthritis showed decreased TS after exercise, both after paracetamol and placebo (P<0.05). In patients with CFS/FM, results were less univocal. A nonsignificant decrease in TS was only observed after taking paracetamol. CPM responses to exercise are inconclusive, but seem to worsen after exercise. No adverse effects were seen. 
Conclusion: This study evaluates pain scores, TS, and CPM in response to submaximal exercise in 2 different chronic pain populations and healthy controls. In patients with RA, exercise had positive effects on TS, suggesting normal EIA. In patients with CFS/FM, these positive effects were only observed after paracetamol and results were inconsistent.},
  author       = {Meeus, Mira and Hermans, Linda and Ickmans, Kelly and Struyf, Filip and Van Cauwenbergh, Deborah and Bronckaerts, Laura and De Clerck, Luc and Moorkens, Greta and Hans, Guy and Grosemans, Sofie and Nijs, Jo},
  issn         = {1530-7085},
  journal      = {PAIN PRACTICE},
  keywords     = {conditioned pain modulation,exercise-induced analgesia,temporal summation,acetaminophen,randomized controlled trial,NOXIOUS INHIBITORY CONTROL,TEMPORAL SUMMATION,2ND PAIN,ACETAMINOPHEN,DEFINITION,ANALGESIA,THERAPY,rheumatoid arthritis,fibromyalgia,chronic fatigue syndrome,pain inhibition,sensitization},
  language     = {eng},
  number       = {2},
  pages        = {98--106},
  title        = {Endogenous pain modulation in response to exercise in patients with rheumatoid arthritis, patients with chronic fatigue syndrome and comorbid fibromyalgia and healthy controls: a double blinded randomized controlled trial},
  url          = {http://dx.doi.org/10.1111/papr.12181},
  volume       = {15},
  year         = {2015},
}

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