The old saying, “No pain, no gain,” may need to be re-evaluated in light of a Norwegian study that brings a new perspective on the relationship between physical activity and pain tolerance.
Rather than associating increased activity with more pain, the research suggests that regular physical activity might actually enhance our ability to withstand it.
According to this study, consistent physical activity may significantly contribute to higher pain tolerance, presenting a potential pathway for managing chronic pain.
The findings from the research were published in the open-access journal PLOS One on Wednesday.
Under the leadership of Anders Arnes from the University Hospital of North Norway, Tromso, the team evaluated data from more than 10,000 adults, a considerably larger and more diverse sample size than analysed in earlier studies.
This large-scale examination allowed for a more precise understanding of the correlation between habitual physical activity and pain tolerance in the general population.
The research team conducted their study by reviewing the data from two rounds of the Tromso Study, a periodic population survey in Norway, collected in 2007-2008 and 2015-2016.
They primarily focused on participants’ self-reported levels of physical activity and their pain tolerance levels, which were assessed through a cold-water hand submersion test.
Through analysis, it was revealed that those who reported being physically active in either round of the Tromso Study had a higher pain tolerance than those who maintained a sedentary lifestyle.
Those who increased their levels of physical activity from 2007-2008 to 2015-2016 also exhibited an overall higher level of pain tolerance.
Physical activities and their effect on pain tolerance
Mr Arnes told The National that the study recorded the average leisure-time physical activity (LTPA) level of participants throughout the year.
Activities varied from sedentary action such as sitting and watching TV to strenuous competitive sports for at least four hours weekly.
The researchers found a substantial correlation between these activities and participants' tolerance to pain.
“Participants' average leisure-time physical activity level throughout the year, whether typically sedentary or strenuous, had a strong relationship with their pain tolerance,” Mr Arnes told The National.
Physical activity was categorised into four areas: sedentary, light, moderate and vigorous LTPA. The data was evaluated using these criteria,
But Mr Arnes said there were could be confounding factors in the study.
“Our models were adjusted for baseline sex, age, education, alcohol consumption frequency, smoking status, self-reported health, occupational physical activity, chronic pain," he said.
"Interestingly, neither sex nor chronic pain moderated the findings.”
The benefits of increased physical activity
Mr Arnes said increasing physical activity correlated with higher pain tolerance.
He said the studies indicated a “more is better” trend, and any level of increased physical activity could be beneficial.
While the analysis did not establish a direct, statistically significant relationship between changes in activity level and pain tolerance between the two study periods, the results suggest a link between maintaining or increasing physical activity and enhanced pain tolerance.
“Becoming or staying physically active over time can benefit your pain tolerance. Whatever you do, the most important thing is that you do something,” the research team commented on their findings.
Mr Arnes said: “The main takeaway is that engaging in habitual physical activity in your leisure time seems to be connected with your pain tolerance – the more active you are, the higher your tolerance is likely to be.
"So the most important take-home message is that any activity is better than being completely sedentary.
“Secondly, there were indications that both total amount of physical activity over time, as well as the direction of change in activity level over time, matters to how high your pain tolerance is.”
The researchers suggest that increasing physical activity could be a viable strategy for mitigating or even preventing chronic pain.
Physiological connections
In discussing potential physiological connections between physical activity and pain tolerance, Mr Arnes highlighted the role of physical activity.
“Engaging in activity releases substances in our nervous system that trigger pain-inhibiting pathways,” he said.
This biological response, coupled with physical activity's benefits of reducing inflammation markers and enhancing psychological mechanisms, creates a framework for improved pain tolerance.
Therapeutic applications and future research
Mr Arnes sees potential therapeutic applications from these findings.
“Since physical activity also appears to be a useful tool for preventing and treating chronic pain, we are trying to ascertain whether its effect on pain tolerance is part of what causes this,” he said.
Mr Arnes shed light on their current research initiatives: “We are exploring whether pain tolerance is a mechanism through which physical activity indirectly affects the risk of chronic pain.
“Habits regarding physical activity are connected to pain tolerance, and this seems to hold true even for those suffering from chronic pain.”
He advocates for increased physical activity among patients, as he believes this is likely to result in better management of their conditions.
