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Does aerobic exercise improve pain perception and mood? A review of the evidence related to healthy and chronic pain subjects


Aerobic exercise can cause an acute improvement in mood as well as a reduction in the perception of pain from a painful stimulus. Regular exercise training also may offer some protection from depression, is clinically useful in treating certain psychiatric and chronic pain conditions, and may allow for an enhancement of the acute improvements in mood from a single exercise session. The utility of aerobic exercise training for improving mood disturbances and pain perception among patients with chronic pain requires further investigation.

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References and Recommended Reading

  1. 1.

    US Department of Health and Human Services: Physical Activity and Health: A Report of the Surgeon General (Publication No. AD-A329 047/5INT). Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; 1996.

    Google Scholar 

  2. 2.

    Pate RR, Pratt M, Blair SN, et al.: Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA, 1995, 273:402–407.

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Brosse AL, Sheets ES, Lett HS, Blumenthal JA: Exercise and the treatment of clinical depression in adults: recent findings and future directions. Sports Med 2002, 32:741–760.

    PubMed  Article  Google Scholar 

  4. 4.

    Fox KR: The influence of physical activity on mental well-being. Public Health Nutr 1999, 2:411–418.

    PubMed  CAS  Article  Google Scholar 

  5. 5.

    Salmon P: Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory. Clin Psychol Rev 2001, 21:33–61.

    PubMed  Article  CAS  Google Scholar 

  6. 6.

    Scully D, Kremer J, Meade MM, et al.: Physical exercise and psychological well being: a critical review. Br J Sports Med 1998, 32:111–120.

    PubMed  CAS  Google Scholar 

  7. 7.

    Barnes DE, Yaffe K, Satariano WA, Tager IB: A longitudinal study of cardiorespiratory fitness and cognitive function in healthy older adults. J Am Geriatr Soc 2003, 51:459–465.

    PubMed  Article  Google Scholar 

  8. 8.

    Kramer AF, Hahn S, Cohen NJ, et al.: Ageing, fitness and neurocognitive function. Nature 1999, 400:418–419.

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    Gatchel RJ: Psychological disorders and chronic pain: cause-and-effect relationship. In Psychological Approaches to Pain Management: A Practitioner’s Handbook. Edited by Gatchel RJ, Turk DC. New York: The Guilford Press; 1996:33–52.

    Google Scholar 

  10. 10.

    Yeung RR: The acute effects of exercise on mood state. J Psychosom Res 1996, 40:123–141.

    PubMed  Article  CAS  Google Scholar 

  11. 11.

    Biddle S: Exercise, emotions, and mental health. In Emotions in Sport. Edited by Hanin YL. Champaign, IL: Human Kinetics; 2000:267–291.

    Google Scholar 

  12. 12.

    Cox RH, Thomas TR, Hinton PS, Donahue OM: Effects of acute 60 and 80% VO2max bouts of aerobic exercise on state anxiety of women of different age groups across time. Res Q Exerc Sport 2004, 75:165–175.

    PubMed  Google Scholar 

  13. 13.

    Thayer RE: Energy, tiredness, and tension effects of a sugar snack versus moderate exercise. J Pers Soc Psychol 1987, 52:119–125.

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Markoff RA, Ryan P, Young T: Endorphins and mood change in long-distance running. Med Sci Sports Exerc 1982, 14:11–15.

    PubMed  CAS  Google Scholar 

  15. 15.

    Raglin JS, Morgan WP: Influence of exercise and quiet rest on state anxiety and blood pressure. Med Sci Sports Exerc 1987, 19:456–463.

    PubMed  CAS  Google Scholar 

  16. 16.

    Maroulakis E, Zervas Y: Effects of aerobic exercise on mood of adult women. Percept Mot Skills 1993, 76:795–801.

    PubMed  CAS  Google Scholar 

  17. 17.

    Shepanski MA, Hoffman MD, Ruble SB, et al.: Habitual exercise is associated with exercise-induced mood enhancement. Med Sci Sports Exerc 2001, 33:S168.

    Article  Google Scholar 

  18. 18.

    Focht BC, Gauvin L, Rejeski WJ: The contribution of daily experiences and acute exercise to fluctuations in daily feeling states among older, obese adults with knee osteoarthritis. J Behav Med 2004, 27:101–121.

    PubMed  Article  Google Scholar 

  19. 19.

    Janal MN, Colt EWD, Clark WC, Glusman M: Pain sensitivity, mood and plasma endocrine levels in man following long-distance running: effects of naloxone. Pain 1984, 19:13–25.

    PubMed  Article  CAS  Google Scholar 

  20. 20.

    Kemppainen P, Paalasmaa P, Pertovaara A, et al.: Dexamethasone attenuates exercise-induced dental analgesia in man. Brain Res 1990, 519: 329–332.

    PubMed  Article  CAS  Google Scholar 

  21. 21.

    Olausson B, Eriksson E, Ellmarker L, et al.: Effects of naloxone on dental pain threshold following muscle exercise and low frequency transcutaneous nerve stimulation: a comparative study in man. Acta Physiol Scand 1986, 126:299–305.

    PubMed  CAS  Google Scholar 

  22. 22.

    Hoffman MD, Clifford PS, MacKenzie SP: Exercise analgesia in persons with chronic low back pain. Med Sci Sports Exerc 2000, 32:S71.

    Google Scholar 

  23. 23.

    Hoffman MD, Shepanski MA, MacKenzie SP, Clifford PS: Experimentally-induced pain perception is acutely reduced by aerobic exercise in persons with chronic low back pain. J Rehabil Res Dev 2005, 42:183–190.

    PubMed  Article  Google Scholar 

  24. 24.

    Hoffman MD, Shepanski MA, Ruble SB, et al.: Intensity and duration threshold for aerobic exercise-induced analgesia to pressure pain. Arch Phys Med Rehabil 2004, 85:1183–1187.

    PubMed  Article  Google Scholar 

  25. 25.

    Koltyn KF, Garvin AW, Gardiner RL, Nelson TF: Perception of pain following aerobic exercise. Med Sci Sports Exerc 1996, 28:1418–1421.

    PubMed  CAS  Google Scholar 

  26. 26.

    Haier RJ, Quaid K, Mills JSC: Naloxone alters pain perception after jogging. Psychiatry Res 1981, 5:231–232.

    PubMed  Article  CAS  Google Scholar 

  27. 27.

    Ruble SB, Hoffman MD, Shepanski MA, et al.: Thermal pain perception after aerobic exercise. Arch Phys Med Rehabil 2005, 86:1019–1023.

    PubMed  Article  Google Scholar 

  28. 28.

    Bruehl S, Chung OY, Ward P, Johnson B: Endogenous opioids and chronic pain intensity: interactions with level of disability. Clin J Pain 2004, 20:283–292.

    PubMed  Article  Google Scholar 

  29. 29.

    Petruzzello SJ, Landers DM, Hatfield BD, et al.: A meta-analysis on the anxiety-reducing effects of acute and chronic exercise. Sports Med 1991, 11:143–182.

    PubMed  CAS  Google Scholar 

  30. 30.

    Wormington JA, Cockerill IM, Nevill AM: Mood alterations with running: the effects of mileage, gender, age and ability. J Hum Mov Stud 1992, 22:1–12.

    Google Scholar 

  31. 31.

    Nichols DS, Glenn TM: Effects of aerobic exercise on pain perception, affect, and level of disability in individuals with fibromyalgia. Phys Ther 1994, 74:327–332.

    PubMed  CAS  Google Scholar 

  32. 32.

    Gowans SE, Dehueck A, Voss S, et al.: Six-month and one-year follow-up of 23 weeks of aerobic exercise for individuals with fibromyalgia. Arthritis Rheum 2004, 51:890–898.

    PubMed  Article  CAS  Google Scholar 

  33. 33.

    Mannerkorpi K, Nyberg B, Ahlmén M, Ekdahl C: Pool exercise combined with an education program of patients with fibromyalgia syndrome. A prospective, randomized study. J Rheumatol 2000, 27:2473–2481.

    PubMed  CAS  Google Scholar 

  34. 34.

    McCain GA, Bell DA, Mai FM, Halliday PD: A controlled study of the effects of a supervised cardiovascular fitness training program on the manifestations of primary fibromyalgia. Arthritis Rheum 1988, 31:1135–1141.

    PubMed  Article  CAS  Google Scholar 

  35. 35.

    Meyer BB, Lemley KJ: Utilizing exercise to affect the symptomology of fibromyalgia: a pilot study. Med Sci Sports Exerc 2000, 32:1691–1697.

    PubMed  Article  CAS  Google Scholar 

  36. 36.

    Jentoft ES, Kvalvik AG, Mengshoel AM: Effects of pool-based and land-based aerobic exercise on women with fibromyalgia/chronic widespread muscle pain. Arthritis Rheum 2001, 45:42–47.

    PubMed  Article  CAS  Google Scholar 

  37. 37.

    Penninx BW, Rejeski WJ, Pandya J, et al.: Exercise and depressive symptoms: a comparison of aerobic and resistance exercise effects on emotional and physical function in older persons with high and low depressive symptomatology. J Gerontol B Psychol Sci Soc Sci 2002, 57:124–132.

    Google Scholar 

  38. 38.

    Minor MA, Hewett JE, Webel RR, et al.: Efficacy of physical conditioning exercise in patients with rheumatoid arthritis and osteoarthritis. Arthritis Rheum 1989, 32:1396–1405.

    PubMed  Article  CAS  Google Scholar 

  39. 39.

    Daltroy LH, Robb-Nicholson C, Iversen MD, et al.: Effectiveness of minimally supervised home aerobic training in patients with systemic rheumatic disease. Br J Rheumatol 1995, 34:1064–1069.

    PubMed  Article  CAS  Google Scholar 

  40. 40.

    Patrick DL, Ramsey SD, Spencer AC, et al.: Economic evaluation of aquatic exercise for persons with osteoarthritis. Med Care 2001, 39:413–424.

    PubMed  Article  CAS  Google Scholar 

  41. 41.

    Brennan GP, Shultz BB, Hood RS, et al.: The effects of aerobic exercise after lumbar microdiscectomy. Spine 1994, 19:735–739.

    PubMed  Article  CAS  Google Scholar 

  42. 42.

    Hicks AL, Martin KA, Ditor DS, et al.: Long-term exercise training in persons with spinal cord injury: effects on strength, arm ergometry performance and psychological well-being. Spinal Cord 2003, 41:34–43.

    PubMed  Article  CAS  Google Scholar 

  43. 43.

    Granges G, Littlejohn GO: A comparative study of clinical signs in fibromyalgia/fibrositis syndrome, healthy and exercising subjects. J Rheumatol 1993, 20:344–351.

    PubMed  CAS  Google Scholar 

  44. 44.

    Janal MN, Glusman M, Kuhl JP, Clark WC: Are runners stoical? An examination of pain sensitivity in habitual runners and normally active controls. Pain 1994, 58:109–116.

    PubMed  Article  CAS  Google Scholar 

  45. 45.

    Ryan ED, Kovacic CR: Pain tolerance and athletic participation. Percept Mot Skills 1966, 22:383–390.

    Google Scholar 

  46. 46.

    Scott V, Gijsbers K: Pain perception in competitive swimmers. Br Med J 1981, 283:91–93.

    CAS  Article  Google Scholar 

  47. 47.

    Moldofsky H, Scarisbrick P, England R, Smythe HA: Musculoskeletal symptoms and nonREM sleep disturbance in patients with “fibrositis syndrome” and healthy subjects. Psychosom Med 1975, 37:341–351.

    PubMed  CAS  Google Scholar 

  48. 48.

    Meiworm L, Jakob E, Walker UA, et al.: Patients with fibromyalgia benefit from aerobic endurance exercise. Clin Rheumatol 2000, 19:253–257.

    PubMed  Article  CAS  Google Scholar 

  49. 49.

    Valim V, Oliveira L, Suda A, et al.: Aerobic fitness effects in fibromyalgia. J Rheumatol 2003, 30:1060–1069.

    PubMed  Google Scholar 

  50. 50.

    Estlander AM, Mellin G, Vanharanta H, Hupli M: Effects and follow-up of a multimodal treatment program including intensive physical training for low back pain patients. Scand J Rehab Med 1991, 23:97–102.

    CAS  Google Scholar 

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Correspondence to Martin D. Hoffman MD.

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Hoffman, M.D., Hoffman, D.R. Does aerobic exercise improve pain perception and mood? A review of the evidence related to healthy and chronic pain subjects. Curr Pain Headache Rep 11, 93–97 (2007).

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  • Chronic Pain
  • Exercise Training
  • Aerobic Exercise
  • Pain Perception
  • Chronic Pain Condition