Effects of exercise-induced hypoalgesia on pressure pain threshold in patients with chronic musculoskeletal pain: A systematic review and meta-analysis.

Study Summary

19 randomized controlled trials including 827 patients with chronic musculoskeletal pain were included in this systematic review and meta-analysis comparing isolated exercise programs with no intervention or other physical therapy modalities. Pooled outcomes focused on pressure pain thresholds among patients with chronic neck-shoulder pain and chronic low back pain, while additional findings were narratively reported for knee osteoarthritis and other chronic musculoskeletal pain conditions. Other physical therapy modalities produced slightly greater improvements in pressure pain thresholds than isolated exercise for both chronic neck-shoulder pain and chronic low back pain. However, the effects were small and the certainty of evidence was low or very low. Overall, isolated exercise was not superior for improving pressure pain thresholds, although these mechanistic findings should not be interpreted as evidence that exercise lacks broader clinical benefit.