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Musculoskeletal pain and exercise—challenging existing paradigms and introducing new

Smith, Toby O; Smith, Benjamin E; Smith, Benjamin E; Hendrick, Paul; Bateman, Marcus; Holden, Sinead; Littlewood, Chris; Smith, Toby O; Logan, Pip

Authors

Toby O Smith

Benjamin E Smith

Benjamin E Smith Benjamin.Smith@nottingham.ac.uk

Paul Hendrick

Marcus Bateman

Sinead Holden

Chris Littlewood

Toby O Smith

Pip Logan



Abstract

Traditional pain models that describe tissue pathology as a source of nocioceptive input directly linked with pain expression, have been insufficient for assessing and treating musculoskeletal pain. The need for pain to be avoided or alleviated as much as possible during physical activity has recently been challenged, with a paradigm shift from traditional biomedical models of pain towards a biopsychosocial model of pain.
The aim of the review is to provide an understanding on the potential mechanisms behind exercise, and to build on this into discussing the additional theoretical mechanisms of painful exercises. Central and peripheral pain mechanisms, the immune system and affective aspects of pain are described. This review focuses on these three mechanisms as these systems appear to respond differently to painful stimulus, compared with necessitating pain-free exercises. They are discussed in relation to the biological effect of exercise for people with chronic pain, with a broader overview of possible mechanisms behind the potentially additional beneficial effect of allowing painful exercises for individuals with chronic musculoskeletal pain.
This additional mechanistic consideration could be used to help clinicians in the prescription of therapeutic exercise and for researchers to advance knowledge for such a globally burdensome condition.

Journal Article Type Article
Publication Date Jun 20, 2018
Journal British Journal of Sports Medicine
Print ISSN 0306-3674
Electronic ISSN 1473-0480
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 53
Issue 14
Pages 907-912
APA6 Citation Smith, B. E., Hendrick, P., Bateman, M., Holden, S., Littlewood, C., Smith, T. O., & Logan, P. (2018). Musculoskeletal pain and exercise—challenging existing paradigms and introducing new. British Journal of Sports Medicine, 53(14), 907-912. https://doi.org/10.1136/bjsports-2017-098983
DOI https://doi.org/10.1136/bjsports-2017-098983
Publisher URL https://bjsm.bmj.com/content/53/14/907
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0


bjsports-2017-098983.full.pdf (418 Kb)
PDF

Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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