Chronic musculoskeletal pain remains a huge challenge for clinicians and researchers. Exercise interventions are the cornerstone of management for musculoskeletal pain conditions, with the benefits being well-established.
The need for pain to be avoided or alleviated as much as possible has been challenged, with a paradigm shift from traditional biomedical models of pain towards a biopsychosocial model of pain, which is particularly relevant in the context of performing therapeutic exercise.
The aim of this article 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.
This online course provides an overview of the current understanding of:
Musculoskeletal pain in relation to central and peripheral pain mechanisms, the immune system and affective aspects of pain. This course focuses on these three mechanisms as these systems may respond differently to painful stimulus, compared with a non-painful stimulus;
Then, the proposed mechanisms behind the potentially additional beneficial effect of allowing painful exercises over pain free exercises for individuals with chronic musculoskeletal pain.