Mit Bewegung gegen den Schmerz – Hypoalgesie durch Training

Hauke Heitkamp; Waclaw Adamczyk; Tibor Szikszay

doi:10.1055/a-2384-5319

physiopraxis, Table of Contents

physiopraxis 2024; 22(10): 26-29
DOI: 10.1055/a-2384-5319

Therapie

Mit Bewegung gegen den Schmerz – Hypoalgesie durch Training

Authors

Hauke Heitkamp
Waclaw Adamczyk
Tibor Szikszay

Abstract

Seit Jahren gibt es einen regelrechten Hype um die übungsinduzierte Hypoalgesie. Schmerz mit Schmerzen hemmen – weshalb das funktionieren kann, wird von der Forschung auf unterschiedliche Arten erklärt. Fest steht, dass zentrale und periphere Mechanismen im Nervensystem die entscheidende Rolle bei diesem Phäomen spielen.

Full Text

References

Literaturverzeichnis
1 George SZ, Fritz JM, Silfies SP. et al. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. J Orthop Sports Phys Ther 2021; 51: CPG1-CPG60
2 Blanpied PR, Gross AR, Elliott JM. et al. Neck Pain: Revision 2017: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Orthopaedic Section of the American Physical Therapy Association. J Orthop Sports Phys Ther 2017; 47: A1-A83
3 Pieters L, Lewis J, Kuppens K. et al. An Update of Systematic Reviews Examining the Effectiveness of Conservative Physical Therapy Interventions for Subacromial Shoulder Pain. J Orthop Sports Phys Ther 2020; 50: 131-141
4 Van Doormaal MCM, Meerhoff GA, Vliet Vlieland TPM. et al. A clinical practice guideline for physical therapy in patients with hip or knee osteoarthritis. Musculoskeletal Care 2020; 18: 575-595
5 Li Y, Su Y, Chen S. et al. The effects of resistance exercise in patients with knee osteoarthritis: a systematic review and meta-analysis. Clin Rehabil 2016; 30: 947-959
6 Rice D, Nijs J, Kosek E.. Exercise-Induced Hypoalgesia in Pain-Free and Chronic Pain Populations: State of the Art and Future Directions. The Journal of Pain 2019; 20: 1249-1266
7 Gross AR, Paquin JP, Dupont G. et al. Exercises for mechanical neck disorders: A Cochrane review update. Manual Therapy 2016; 24: 25-45
8 Hayden J, Van Tulder MW, Malmivaara A. et al. Exercise therapy for treatment of non-specific low back pain. Cochrane Database of Systematic Reviews 2005; 2011
9 Hernández-Molina G, Reichenbach S, Zhang B. et al. Effect of therapeutic exercise for hip osteoarthritis pain: Results of a meta‐analysis. Arthritis & Rheumatism 2008; 59: 1221-1228
10 Kemppainen P, Paalasmaa P, Pertovaara A. et al. Dexamethasone attenuates exercise-induced dental analgesia in man. Brain Research 1990; 519: 329-332
11 Naugle KM, Fillingim RB, Riley JL.. A Meta-Analytic Review of the Hypoalgesic Effects of Exercise. The Journal of Pain 2012; 13: 1139-1150
12 Hoffman MD, Shepanski MA, Ruble SB. et al. Intensity and duration threshold for aerobic exercise-induced analgesia to pressure pain. Archives of Physical Medicine and Rehabilitation 2004; 85: 1183-1187
13 Naugle KM, Naugle KE, Riley JL.. Reduced Modulation of Pain in Older Adults After Isometric and Aerobic Exercise. The Journal of Pain 2016; 17: 719-728
14 Vaegter HB, Jones MD.. Exercise-induced hypoalgesia after acute and regular exercise: experimental and clinical manifestations and possible mechanisms in individuals with and without pain. PAIN Reports 2020; 5: e823
15 Wewege MA, Jones MD.. Exercise-Induced Hypoalgesia in Healthy Individuals and People With Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis. The Journal of Pain 2021; 22: 21-31
16 Ossipov MH, Morimura K, Porreca F.. Descending pain modulation and chronification of pain. Current Opinion in Supportive & Palliative Care 2014; 8: 143-151
17 Vaegter HB, Bjerregaard LK, Redin M-M. et al. Hypoalgesia after bicycling at lactate threshold is reliable between sessions. Eur J Appl Physiol 2019; 119: 91-102
18 Scheef L, Jankowski J, Daamen M. et al. An fMRI study on the acute effects of exercise on pain processing in trained athletes. Pain 2012; 153: 1702-1714
19 Ellingson LD, Koltyn KF, Kim J. et al. Does exercise induce hypoalgesia through conditioned pain modulation?. Psychophysiology 2014; 51: 267-276
20 Yarnitsky D.. Conditioned pain modulation (the diffuse noxious inhibitory control-like effect): its relevance for acute and chronic pain states. Current Opinion in Anaesthesiology 2010; 23: 611-615
21 Schliessbach J, Lütolf C, Streitberger K. et al. Reference values of conditioned pain modulation. Scandinavian Journal of Pain 2019; 19: 279-286
22 Nir R-R, Yarnitsky D.. Conditioned pain modulation. Current Opinion in Supportive & Palliative Care 2015; 9: 131-137
23 McPhee ME, Vaegter HB, Graven-Nielsen T.. Alterations in pronociceptive and antinociceptive mechanisms in patients with low back pain: a systematic review with meta-analysis. Pain 2020; 161: 464-475
24 Lesnak JB, Sluka KA.. Mechanism of exercise-induced analgesia: what we can learn from physically active animals. PR9 2020; 5: e850
25 Lima LV, Abner TSS, Sluka KA.. Does exercise increase or decrease pain? Central mechanisms underlying these two phenomena. The Journal of Physiology 2017; 595: 4141-4150
26 Bement MKH, Sluka KA.. Low-Intensity Exercise Reverses Chronic Muscle Pain in the Rat in a Naloxone-Dependent Manner. Archives of Physical Medicine and Rehabilitation 2005; 86: 1736-1740
27 Wu B, Zhou L, Chen C. et al. Effects of Exercise-induced Hypoalgesia and Its Neural Mechanisms. Medicine and science in sports and exercise 2022; 54: 220-231
28 Melzack R, Wall PD.. Pain Mechanisms: A New Theory. Science 1965; 150: 971-979
29 Mendell LM.. Constructing and deconstructing the gate theory of pain. Pain 2014; 155: 210-216
30 Koltyn KF, Umeda M.. Exercise, hypoalgesia and blood pressure. Sports medicine (Auckland, NZ) 2006; 36: 207-214
31 Peterson JA, Lohman C, Larson RD. et al. Body composition does not influence conditioned pain modulation and exercise-induced hyperalgesia in healthy males and females. European Journal of Pain 2022; 26: 1800-1810
32 Hatamochi A, Mori K, Ueki H.. Role of cytokines in controlling connective tissue gene expression. Archives of dermatological research 1994; 287: 115-121
33 Zhang J-M, An J.. Cytokines, inflammation, and pain. International anesthesiology clinics 2007; 45: 27-37
34 Docherty S, Harley R, McAuley JJ. et al. The effect of exercise on cytokines: BMC Sports Science, Medicine and Rehabilitation. 2022; 1-14
35 Ji R-R, Chamessian A, Zhang Y-Q.. Pain regulation by non-neuronal cells and inflammation. Science 2016; 354: 572-577
36 Gonçalves Dos Santos G, Delay L, Yaksh TL. et al. Neuraxial Cytokines in Pain States. Frontiers in immunology 2019; 10: 3061
37 Eitner A, Richter F, Schaible H-G.. Physiologie der Schmerzentstehung in der Peripherie. Physiology of Pain Generation in the Periphery. Aktuelle Rheumatologie 2020; 45: 402-412
38 Uçeyler N, Valenza R, Stock M. et al. Reduced levels of antiinflammatory cytokines in patients with chronic widespread pain. Arthritis and rheumatism 2006; 54: 2656-2664
39 Steen-Louws C, Popov-Celeketic J, Mastbergen SC. et al. IL4-10 fusion protein has chondroprotective, anti-inflammatory and potentially analgesic effects in the treatment of osteoarthritis. Osteoarthritis and cartilage 2018; 26: 1127-1135
40 Chow LS, Gerszten RE, Taylor JM. et al. Exerkines in health, resilience and disease. Nature reviews Endocrinology 2022; 18: 273-289
41 Pedersen BK, Febbraio MA.. Muscle as an endocrine organ: focus on muscle-derived interleukin-6. Physiological reviews 2008; 88: 1379-1406
42 Helmark IC, Mikkelsen UR, Borglum J. et al. Exercise increases interleukin-10 levels both intraarticularly and peri-synovially in patients with knee osteoarthritis: a randomized controlled trial. Arthritis Research & Therapy 2010; 12: 1-11
43 Steensberg A, van Hall G, Osada T. et al. Production of interleukin-6 in contracting human skeletal muscles can account for the exercise-induced increase in plasma interleukin-6. Journal of Physiology-London 2000; 529: 237-242
44 Kjeldsen T, Hvidt KJ, Bohn MB. et al. Exercise compared to a control condition or other conservative treatment options in patients with Greater Trochanteric Pain Syndrome: a systematic review and meta-analysis of randomized controlled trials. Physiotherapy 2024; 123: 69-80
45 Faas A, Chavannes AW, van Eijk JT. et al. A randomized, placebo-controlled trial of exercise therapy in patients with acute low back pain. Spine (Phila Pa 1976) 1993; 18: 1388-1395
46 IJzelenberg W, Oosterhuis T, Hayden JA. et al. Exercise therapy for treatment of acute non-specific low back pain. Cochrane Database of Systematic Reviews 2023; 2023
47 Vase L, Riley JL, Price DD.. A comparison of placebo effects in clinical analgesic trials versus studies of placebo analgesia. Pain 2002; 99: 443-452
48 Cormier S, Lavigne GL, Choinière M. et al. Expectations predict chronic pain treatment outcomes. Pain 2016; 157: 329-338
49 Colloca L, Miller FG.. How placebo responses are formed: a learning perspective. Philos Trans R Soc Lond B Biol Sci 2011; 366: 1859-1869
50 Colloca L, Benedetti F.. How prior experience shapes placebo analgesia. Pain 2006; 124: 126-133
51 Crum AJ, Langer EJ.. Mind-Set Matters: Exercise and the Placebo Effect. Psychol Sci 2007; 18: 165-171
52 Vaegter HB, Thinggaard P, Madsen CH. et al. Power of Words: Influence of Preexercise Information on Hypoalgesia after Exercise—Randomized Controlled Trial. Medicine & Science in Sports & Exercise 2020; 52: 2373-2379