Mechanisms of chronic pain – key considerations for appropriate physical therapy management

References

• Johannes CB, Le TK, Zhou X, et al. The prevalence of chronic pain in United States adults: results of an internet-based survey. J Pain. 2010;11:1230–1239. doi:10.1016/j.jpain.2010.07.002.
   PubMed Web of Science ®Google Scholar
• IOM. Relieving pain in America: A blueprint for transforming prevention, care, education, and research. Washington, DC: The National Academies Press; 2011.
   Google Scholar
• Fayaz A, Croft P, Langford RM, et al. Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ Open. 2016;6:2015–010364. doi:10.1136/bmjopen-2015-010364.
   Web of Science ®Google Scholar
• Schäfer I, Kaduszkiewicz H, Wagner HO, et al. Reducing complexity: a visualisation of multimorbidity by combining disease clusters and triads. BMC Public Health. 2014;14:101, 2458-14-1285. doi:10.1186/1471-2458-14-1285.
   PubMed Web of Science ®Google Scholar
• Morales-Espinoza EM, Kostov B, Salami DC, et al. Complexity, comorbidity, and health care costs associated with chronic widespread pain in primary care. Pain. 2016;157:818–826. doi:10.1097/j.pain.0000000000000440.
   PubMed Web of Science ®Google Scholar
• Novak SP, Glasheen C, Roland CL. Prescription pain reliever misuse and levels of pain impairment: 3-year course in a nationally representative outpatient sample of US adults. Subst Abuse Rehabil. 2016;7:87–98. doi:10.2147/SAR.S102251.
   PubMed Web of Science ®Google Scholar
• Jimenez-Sanchez S, Jimenez-Garcia R, Hernandez-Barrera V, et al. Has the prevalence of invalidating musculoskeletal pain changed over the last 15 years (1993-2006)? A Spanish population-based survey. J Pain. 2010;11:612–620. doi:10.1016/j.jpain.2009.09.015.
   PubMed Web of Science ®Google Scholar
• Sluka KA, O’Donnell JM, Danielson J, et al. Regular physical activity prevents development of chronic pain and activation of central neurons. J Appl Physiol. 1985;2013:725–733. doi:10.1152/japplphysiol.01317.2012.
   Web of Science ®Google Scholar
• Atluri S, Sudarshan G, Manchikanti L. Assessment of the trends in medical use and misuse of opioid analgesics from 2004 to 2011. Pain Physician. 2014;17:E119–28.
   PubMed Web of Science ®Google Scholar
• International Association for the Study of Pain Proposed Pain Terminology. Available from: http://www.iasp-pain.org/AM/Template.cfm?Section=Pain_Definitions&Template=/CM/HTMLDisplay.cfm&ContentID=1728
   Google Scholar
• Jensen MP, Tome-Pires C, de la Vega R, et al. What determines whether a pain is rated as mild, moderate, or severe? The importance of pain beliefs and pain interference. Clin J Pain. 2016. [Epub ahead of print]. doi:10.1097/AJP.0000000000000429.
   Web of Science ®Google Scholar
• Sluka KA, Clauw DJ. Neurobiology of fibromyalgia and chronic widespread pain. Neuroscience. 2016;338:114–129. doi:10.1016/j.neuroscience.2016.06.006.
   PubMed Web of Science ®Google Scholar
• Cimmino MA, Ferrone C, Cutolo M. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol. 2011;25:173–183. doi:10.1016/j.berh.2010.01.012.
   PubMed Web of Science ®Google Scholar
• Carli G, Suman AL, Biasi G, et al. Reactivity to superficial and deep stimuli in patients with chronic musculoskeletal pain. Pain. 2002;100:259–269. doi:S030439590200297X [pii].
   PubMed Web of Science ®Google Scholar
• Dworkin RH, Turk DC, Peirce-Sandner S, et al. Research design considerations for confirmatory chronic pain clinical trials: IMMPACT recommendations. Pain. 2010;149:177–193. doi:10.1016/j.pain.2010.02.018.
   PubMed Web of Science ®Google Scholar
• Elliott AM, Smith BH, Penny KI, et al. The epidemiology of chronic pain in the community. Lancet. 1999;354:1248–1252. doi:S0140673699030573 [pii].
   PubMed Web of Science ®Google Scholar
• May A, Schulte LH. Chronic migraine: risk factors, mechanisms and treatment. Nat Rev Neurol. 2016;12:455–464. doi:10.1038/nrneurol.2016.93.
   PubMed Web of Science ®Google Scholar
• Stewart Williams J, Ng N, Peltzer K, et al. Risk factors and disability associated with low back pain in older adults in low- and middle-income countries. results from the WHO study on global ageing and adult health (SAGE). PLos One. 2015;10:e0127880. doi:10.1371/journal.pone.0127880.
   PubMed Web of Science ®Google Scholar
• Abásolo L, Lajas C, León L, et al. Prognostic factors for long-term work disability due to musculoskeletal disorders. Rheumatol Int. 2012;32:3831–3839. doi:10.1007/s00296-011-2264-5.
   PubMed Web of Science ®Google Scholar
• Hung M, Bounsanga J, Voss MW, et al. The relationship between family support; pain and depression in elderly with arthritis. Psychol Health Med. 2016;22:1–12. doi:10.1080/13548506.2016.1211293.
   PubMed Web of Science ®Google Scholar
• Spiegel DR, Shaukat AM, Mccroskey AL, et al. Conceptualizing a subtype of patients with chronic pain: the necessity of obtaining a history of sexual abuse. Int J Psychiatry Med. 2016;51:84–103. doi:10.1177/0091217415621268.
   PubMed Web of Science ®Google Scholar
• Paras ML, Murad MH, Chen LP, et al. Sexual abuse and lifetime diagnosis of somatic disorders: a systematic review and meta-analysis. JAMA. 2009;302:550–561. doi:10.1001/jama.2009.1091.
   PubMed Web of Science ®Google Scholar
• Kellner U, Halder C, Litschi M, et al. Pain and psychological health status in chronic pain patients with migration background–the Zurich study. Clin Rheumatol. 2013;32:189–197. doi:10.1007/s10067-012-2099-9.
   PubMed Web of Science ®Google Scholar
• Mason P. Deconstructing endogenous pain modulations. J Neurophysiol. 2005;94:1659–1663. doi:10.1152/jn.00249.2005.
   PubMed Web of Science ®Google Scholar
• Palermo TM, Wilson AC, Lewandowski AS, et al. Behavioral and psychosocial factors associated with insomnia in adolescents with chronic pain. Pain. 2011;152:89–94. doi:10.1016/j.pain.2010.09.035.
   PubMed Web of Science ®Google Scholar
• Bjurstrom MF, Irwin MR. Polysomnographic characteristics in nonmalignant chronic pain populations: A review of controlled studies. Sleep Med Rev. 2016;26:74–86. doi:10.1016/j.smrv.2015.03.004.
   PubMed Web of Science ®Google Scholar
• Ancoli-Israel S, Soares CN, Gaeta R, et al. Insomnia in special populations: effects of aging, menopause, chronic pain, and depression. Postgrad Med. 2004;116:33–47. doi:10.3810/pgm.12.2004.suppl38.260.
   PubMedGoogle Scholar
• Coronado RA, Alappattu MJ, Hart DL, et al. Total number and severity of comorbidities do not differ based on anatomical region of musculoskeletal pain. J Orthop Sports Phys Ther. 2011;41:477–485. doi:10.2519/jospt.2011.3686.
   PubMed Web of Science ®Google Scholar
• Burke AL, Mathias JL, Denson LA. Psychological functioning of people living with chronic pain: a meta-analytic review. Br J Clin Psychol. 2015;54:345–360. doi:10.1111/bjc.12078.
   PubMed Web of Science ®Google Scholar
• Burke NN, Finn DP, Roche M. Neuroinflammatory Mechanisms linking pain and depression. Mod Trends Pharmacopsychiatri. 2015;30:36–50. doi:10.1159/000435931.
   PubMedGoogle Scholar
• Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science. 2000;288:1765–1768. doi:10.1126/science.288.5472.1765.
   PubMed Web of Science ®Google Scholar
• Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152:S2–S15. doi:10.1016/j.pain.2010.09.030.
   PubMed Web of Science ®Google Scholar
• Sterling M, Pedler A, Chan C, et al. Cervical lateral glide increases nociceptive flexion reflex threshold but not pressure or thermal pain thresholds in chronic whiplash associated disorders: a pilot randomised controlled trial. Man Ther. 2010;15:149–153. doi:10.1016/j.math.2009.09.004.
   PubMed Web of Science ®Google Scholar
• Courtney CA, Lewek MD, Witte PO, et al. Heightened flexor withdrawal responses in subjects with knee osteoarthritis. J Pain. 2009;10:1242–1249. doi:10.1016/j.jpain.2009.05.004.
   PubMed Web of Science ®Google Scholar
• Courtney CA, Durr RK, Emerson-Kavchak AJ, et al. Heightened flexor withdrawal responses following ACL rupture are enhanced by passive tibial translation. Clin Neurophysiol. 2011;122:1005–1010. doi:10.1016/j.clinph.2010.07.029.
   PubMed Web of Science ®Google Scholar
• Lim EC, Sterling M, Pedler A, et al. Evidence of spinal cord hyperexcitability as measured with nociceptive flexion reflex (NFR) threshold in chronic lateral epicondylalgia with or without a positive neurodynamic test. J Pain. 2012;13:676–684. doi:10.1016/j.jpain.2012.04.005.
   PubMed Web of Science ®Google Scholar
• Wilder-Smith CH, Schindler D, Lovblad K, et al. Brain functional magnetic resonance imaging of rectal pain and activation of endogenous inhibitory mechanisms in irritable bowel syndrome patient subgroups and healthy controls. Gut. 2004;53:1595–1601. doi:10.1136/gut.2003.028514.
   PubMed Web of Science ®Google Scholar
• Perrotta A, Serrao M, Sandrini G, et al. Sensitisation of spinal cord pain processing in medication overuse headache involves supraspinal pain control. Cephalalgia. 2010;30:272–284. doi:10.1111/j.1468-2982.2009.01914.x.
   PubMed Web of Science ®Google Scholar
• Arendt-Nielsen L, Nie H, Laursen MB, et al. Sensitization in patients with painful knee osteoarthritis. Pain. 2010;149:573–581. doi:10.1016/j.pain.2010.04.003.
   PubMed Web of Science ®Google Scholar
• Courtney CA, Steffen AD, Fernandez-de-Las-Penas C, et al. Joint mobilization enhances mechanisms of conditioned pain modulation in individuals with osteoarthritis of the knee. J Orthop Sports Phys Ther. 2016;46:168–176. doi:10.2519/jospt.2016.6259.
   PubMed Web of Science ®Google Scholar
• Walsh DA, Mapp PI, Kelly S. Calcitonin gene-related peptide in the joint: contributions to pain and inflammation. Br J Clin Pharmacol. 2015;80:965–978. doi:10.1111/bcp.12669.
   PubMed Web of Science ®Google Scholar
• Ji RR, Kohno T, Moore KA, et al. Central sensitization and LTP: do pain and memory share similar mechanisms? Trends Neurosci. 2003;26:696–705.10.1016/j.tins.2003.09.017
   PubMed Web of Science ®Google Scholar
• Neumann S, Doubell TP, Leslie T, et al. Inflammatory pain hypersensitivity mediated by phenotypic switch in myelinated primary sensory neurons. Nature. 1996;384:360–364. doi:10.1038/384360a0.
   PubMed Web of Science ®Google Scholar
• Latremoliere A, Woolf CJ. Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J Pain. 2009;10:895–926. doi:10.1016/j.jpain.2009.06.012.
   PubMed Web of Science ®Google Scholar
• Treede RD, Magerl W. Multiple mechanisms of secondary hyperalgesia. Prog Brain Res. 2000;129:331–341. doi:S0079-6123(00)29025-0 [pii].
   PubMedGoogle Scholar
• Arendt-Nielsen L, Graven-Nielsen T. Translational musculoskeletal pain research. Best Pract Res Clin Rheumatol. 2011;25:209–226. doi:10.1016/j.berh.2010.01.013.
   PubMed Web of Science ®Google Scholar
• Woolf CJ. Evidence for a central component of post-injury pain hypersensitivity. Nature. 1983;306:686–688.10.1038/306686a0
   PubMed Web of Science ®Google Scholar
• Arendt-Nielsen L, Skou ST, Nielsen TA, et al. Altered central sensitization and pain modulation in the CNS in chronic joint pain. Curr Osteoporos Rep. 2015;13:225–234. doi:10.1007/s11914-015-0276-x.
   PubMed Web of Science ®Google Scholar
• Schliessbach J, Siegenthaler A, Streitberger K, et al. The prevalence of widespread central hypersensitivity in chronic pain patients. Eur J Pain. 2013;17:1502–1510. doi:10.1002/j.1532-2149.2013.00332.x.
   PubMed Web of Science ®Google Scholar
• Courtney CA, Kavchak AE, Lowry CD, et al. Interpreting joint pain: quantitative sensory testing in musculoskeletal management. J Orthop Sports Phys Ther. 2010;40:818–825. doi:10.2519/jospt.2010.3314.
   PubMed Web of Science ®Google Scholar
• de Tommaso M, Fernandez-de-Las-Penas C. Tension type headache. Curr Rheumatol Rev. 2016;12:127–139. doi:10.2174/1573397112666151231113625.
   PubMed Web of Science ®Google Scholar
• Fernandez-de-las-Penas C, de la Llave-Rincon AI, Fernandez-Carnero J, et al. Bilateral widespread mechanical pain sensitivity in carpal tunnel syndrome: evidence of central processing in unilateral neuropathy. Brain. 2009;132:1472–1479. doi:10.1093/brain/awp050.
   PubMed Web of Science ®Google Scholar
• Sanzarello I, Merlini L, Rosa MA, et al. Central sensitization in chronic low back pain: A narrative review. J Back Musculoskelet Rehabil. 2016;29:625–633. doi:10.3233/BMR-160685.
   PubMed Web of Science ®Google Scholar
• Stabell N, Stubhaug A, Flægstad T, et al. Widespread hyperalgesia in adolescents with symptoms of irritable bowel syndrome: results from a large population-based study. J Pain. 2014;15:898–906. doi:10.1016/j.jpain.2014.05.007.
   PubMed Web of Science ®Google Scholar
• Palacios-Ceña M, Lima Florencio L, Natália Ferracini G, et al. Women with chronic and episodic migraine exhibit similar widespread pressure pain sensitivity. Pain Med. 2016;17:2127–2133. doi:10.1093/pm/pnw056.
   PubMed Web of Science ®Google Scholar
• Rolke R, Baron R, Maier C, et al. Quantitative sensory testing: a comprehensive protocol for clinical trials. Eur J Pain. 2006;10:77–88. doi:10.1016/j.ejpain.2005.02.003.
   PubMed Web of Science ®Google Scholar
• Kim YH, Back SK, Davies AJ, et al. TRPV1 in GABAergic interneurons mediates neuropathic mechanical allodynia and disinhibition of the nociceptive circuitry in the spinal cord. Neuron. 2012;74:640–647. doi:10.1016/j.neuron.2012.02.039.
   PubMed Web of Science ®Google Scholar
• Jarrell J. Demonstration of cutaneous allodynia in association with chronic pelvic pain. J Vis Exp 2009;28. pii: 1232. doi:10.3791/1232.
   Google Scholar
• Kavchak AJ, Fernández-de-las-Peñas C, Rubin LH, et al. Association between altered somatosensation, pain, and knee stability in patients with severe knee osteoarthrosis. Clin J Pain. 2012;28:589–594. doi:10.1097/AJP.0b013e31823ae18f.
   PubMed Web of Science ®Google Scholar
• Hansson P, Backonja M, Bouhassira D. Usefulness and limitations of quantitative sensory testing: clinical and research application in neuropathic pain states. Pain. 2007;129:256–259. doi:10.1016/j.pain.2007.03.030.
   PubMed Web of Science ®Google Scholar
• Xing H, Chen M, Ling J, et al. TRPM8 mechanism of cold allodynia after chronic nerve injury. J Neurosci. 2007;27:13680–13690. doi:10.1523/JNEUROSCI.2203-07.2007.
   PubMed Web of Science ®Google Scholar
• Raja SN, Campbell JN, Meyer RA. Evidence for different mechanisms of primary and secondary hyperalgesia following heat injury to the glabrous skin. Brain. 1984;107:1179–1188.10.1093/brain/107.4.1179
   PubMed Web of Science ®Google Scholar
• de Medinaceli L, Hurpeau J, Merle M, et al. Cold and post-traumatic pain: modeling of the peripheral nerve message. Biosystems. 1997;43:145–167. doi:S0303264797016857 [pii].
   PubMed Web of Science ®Google Scholar
• de la Llave-Rincon AI, Fernandez-de-las-Penas C, Fernandez-Carnero J, et al. Bilateral hand/wrist heat and cold hyperalgesia, but not hypoesthesia, in unilateral carpal tunnel syndrome. Exp Brain Res. 2009;198:455–463. doi:10.1007/s00221-009-1941-z.
   PubMed Web of Science ®Google Scholar
• Fernandez-de-Las-Penas C, Fernandez-Munoz JJ, Navarro-Pardo E, et al. Identification of subgroups of women with carpal tunnel syndrome with central sensitization. Pain Med 2016;17:1749-1756 doi:10.1093/pm/pnw054.
   PubMed Web of Science ®Google Scholar
• Coombes BK, Bisset L, Vicenzino B. Thermal hyperalgesia distinguishes those with severe pain and disability in unilateral lateral epicondylalgia. Clin J Pain. 2012;28:595–601. doi:10.1097/AJP.0b013e31823dd333.
   PubMed Web of Science ®Google Scholar
• Rakel B, Vance C, Zimmerman MB, et al. Mechanical hyperalgesia and reduced quality of life occur in people with mild knee osteoarthritis pain. Clin J Pain. 2015;31:315–322. doi:10.1097/AJP.0000000000000116.
   PubMed Web of Science ®Google Scholar
• Jensen R, Hystad T, Kvale A, et al. Quantitative sensory testing of patients with long lasting Patellofemoral pain syndrome. Eur J Pain. 2007;11:665–676. doi:10.1016/j.ejpain.2006.10.007.
   PubMed Web of Science ®Google Scholar
• Coronado RA, Kindler LL, Valencia C, et al. Thermal and pressure pain sensitivity in patients with unilateral shoulder pain: comparison of involved and uninvolved sides. J Orthop Sports Phys Ther. 2011;41:165–173. doi:10.2519/jospt.2011.3416.
   PubMed Web of Science ®Google Scholar
• Apkarian AV, Stea RA, Bolanowski SJ. Heat-induced pain diminishes vibrotactile perception: a touch gate. Somatosens Mot Res. 1994;11:259–267.10.3109/08990229409051393
   PubMed Web of Science ®Google Scholar
• Geber C, Magerl W, Fondel R, et al. Numbness in clinical and experimental pain – a cross-sectional study exploring the mechanisms of reduced tactile function. Pain. 2008;139:73–81. doi:10.1016/j.pain.2008.03.006.
   PubMed Web of Science ®Google Scholar
• Hornby TG, Rymer WZ, Benz EN, et al. Windup of flexion reflexes in chronic human spinal cord injury: a marker for neuronal plateau potentials? J Neurophysiol. 2003;89:416–426. doi:10.1152/jn.00979.2001.
   PubMed Web of Science ®Google Scholar
• Arendt-Nielsen L. Central sensitization in humans: assessment and pharmacology. Handb Exp Pharmacol. 2015;227:79–102. doi:10.1007/978-3-662-46450-2_5.
   PubMedGoogle Scholar
• Bialosky JE, Bishop MD, Robinson ME, et al. Spinal manipulative therapy has an immediate effect on thermal pain sensitivity in people with low back pain: a randomized controlled trial. Phys Ther. 2009;89:1292–1303. doi:10.2522/ptj.20090058.
   PubMed Web of Science ®Google Scholar
• Lewis GN, Rice DA, McNair PJ. Conditioned pain modulation in populations with chronic pain: a systematic review and meta-analysis. J Pain. 2012;13:936–944. doi:10.1016/j.jpain.2012.07.005.
   PubMed Web of Science ®Google Scholar
• Nijs J, Roussel N, Paul van Wilgen C, et al. Thinking beyond muscles and joints: therapists’ and patients’ attitudes and beliefs regarding chronic musculoskeletal pain are key to applying effective treatment. Man Ther. 2013;18:96–102. doi:10.1016/j.math.2012.11.001.
   PubMed Web of Science ®Google Scholar
• Nijs J, Van Houdenhove B. From acute musculoskeletal pain to chronic widespread pain and fibromyalgia: application of pain neurophysiology in manual therapy practice. Man Ther. 2009;14:3–12. doi:10.1016/j.math.2008.03.001.
   PubMed Web of Science ®Google Scholar
• Archer KR, Devin CJ, Vanston SW, et al. Cognitive-behavioral–based physical therapy for patients with chronic pain undergoing lumbar spine surgery: a randomized controlled trial. J Pain. 2016;17:76–89. doi:10.1016/j.jpain.2015.09.013.
   PubMed Web of Science ®Google Scholar
• Neogi T, Guermazi A, Roemer F, et al. Association of joint inflammation with pain sensitization in knee osteoarthritis: the multicenter osteoarthritis study. Arthritis Rheumatol. 2016;68:654–661. doi:10.1002/art.39488.
   PubMed Web of Science ®Google Scholar
• Arendt-Nielsen L, Egsgaard LL, Petersen KK. Evidence for a central mode of action for etoricoxib (COX-2 inhibitor) in patients with painful knee osteoarthritis. Pain. 2016;157:1634–1644. doi:10.1097/j.pain.0000000000000562.
   PubMed Web of Science ®Google Scholar
• Schug SA, Goddard C. Recent advances in the pharmacological management of acute and chronic pain. Ann Palliat Med. 2014;3:263–275. doi:10.3978/j.issn.2224-5820.2014.10.02.
   PubMedGoogle Scholar
• Rice DA, McNair PJ, Lewis GN, et al. The effects of joint aspiration and intra-articular corticosteroid injection on flexion reflex excitability, quadriceps strength and pain in individuals with knee synovitis: a prospective observational study. Arthritis Res Ther. 2015;17:191, 015-0711-5 doi:10.1186/s13075-015-0711-5.
   PubMed Web of Science ®Google Scholar
• Vergnolle N. Postinflammatory visceral sensitivity and pain mechanisms. Neurogastroenterol Motil. 2008;20(Suppl 1):73–80. doi:10.1111/j.1365-2982.2008.01110.x.
   PubMed Web of Science ®Google Scholar
• Koltyn KF, Brellenthin AG, Cook DB, et al. Mechanisms of exercise-induced hypoalgesia. J Pain. 2014;15:1294–1304. doi:10.1016/j.jpain.2014.09.006.
   PubMed Web of Science ®Google Scholar
• Staud R. Is it all central sensitization? role of peripheral tissue nociception in chronic musculoskeletal pain. Curr Rheumatol Rep. 2010;12:448–454. doi:10.1007/s11926-010-0134-x.
   PubMedGoogle Scholar
• Mollayeva T, Thurairajah P, Burton K, et al. The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: a systematic review and meta-analysis. Sleep Med Rev. 2016;25:52–73. doi:10.1016/j.smrv.2015.01.009.
   PubMed Web of Science ®Google Scholar
• Nishiyama T, Mizuno T, Kojima M, et al. Criterion validity of the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale for the diagnosis of sleep disorders. Sleep Med. 2014;15:422–429. doi:10.1016/j.sleep.2013.12.015.
   PubMed Web of Science ®Google Scholar
• Turk DC, Dworkin RH, Revicki D, et al. Identifying important outcome domains for chronic pain clinical trials: An IMMPACT survey of people with pain. Pain. 2008;137:276–285. doi:10.1016/j.pain.2007.09.002.
   PubMed Web of Science ®Google Scholar
• Vaegter HB, Handberg G, Graven-Nielsen T. Hypoalgesia after exercise and the cold pressor test is reduced in chronic musculoskeletal pain patients with high pain sensitivity. Clin J Pain. 2016;32:58–69. doi:10.1097/AJP.0000000000000223 [pii].
   PubMed Web of Science ®Google Scholar
• Hoffman MD, Shepanski MA, MacKenzie SP, et al. Experimentally induced pain perception is acutely reduced by aerobic exercise in people with chronic low back pain. J Rehabil Res Dev. 2005;42:183–190.10.1682/JRRD.2004.06.0065
   PubMed Web of Science ®Google Scholar
• Lidegaard M, Jensen RB, Andersen CH, et al. Effect of brief daily resistance training on occupational neck/shoulder muscle activity in office workers with chronic pain: randomized controlled trial. Biomed Res Int. 2013;2013:262386. doi:10.1155/2013/262386.
   PubMed Web of Science ®Google Scholar
• Sundstrup E, Jakobsen MD, Brandt M, et al. Workplace strength training prevents deterioration of work ability among workers with chronic pain and work disability: a randomized controlled trial. Scand J Work Environ Health. 2014;40:244–251. doi:10.5271/sjweh.3419.
   PubMed Web of Science ®Google Scholar
• Hoeger Bement MK, Dicapo J, Rasiarmos R, et al. Dose response of isometric contractions on pain perception in healthy adults. Med Sci Sports Exerc. 2008;40:1880–1889. doi:10.1249/MSS.0b013e31817eeecc.
   PubMed Web of Science ®Google Scholar
• Defrin R, Ariel E, Peretz C. Segmental noxious versus innocuous electrical stimulation for chronic pain relief and the effect of fading sensation during treatment. Pain. 2005;115:152–160. doi:10.1016/j.pain.2005.02.018.
   PubMed Web of Science ®Google Scholar
• Eckenrode BJ, Stackhouse SK. Improved pressure pain thresholds and function following noxious electrical stimulation on a runner with chronic achilles tendinopathy: a case report. Int J Sports Phys Ther. 2015;10:354–362.
   PubMedGoogle Scholar