Suprathreshold heat pain response predicts activity-related pain, but not rest-related pain, in an exercise-induced injury model

Exercise-induced injury models are useful for studying pain since the onset of pain is controlled and both pre-injury and post-injury factors can be utilized as explanatory variables or predictors. In these studies, rest-related pain is frequently considered the primary dependent variable or outcome, as opposed to a measure of activity-related pain. In addition, few studies include pain sensitivity measures as predictors. This study examined the influence of pre-injury and post-injury factors, including pain sensitivity, for induced rest and activity-related pain after exercise induced muscle injury. The overall goal of this investigation was to determine if there were convergent or divergent predictors of rest and activity-related pain. One hundred forty-three participants provided demographic, psychological, and pain sensitivity information and underwent a standard fatigue trial of resistance exercise to induce injury of the dominant shoulder. Pain at rest and during active and resisted shoulder motion were measured at 48- and 96-hours post-injury. Separate hierarchical models were generated for assessing the influence of pre-injury and post-injury factors on 48- and 96-hour rest-related and activity-related pain. Overall, no universal predictor of pain across all models was found. However, pre-injury and post-injury suprathreshold heat pain response (SHPR), a pain sensitivity measure, was a consistent predictor of activity-related pain, even after controlling for known psychological factors.

These results imply there is differential prediction of pain. A measure of pain sensitivity such as SHPR appears more influential for activity-related pain, but not rest-related pain, and may reflect different underlying processes involved during pain appraisal.

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