Role of Exercise in Alleviating Chronic Pain in SCI

Abstract

Four out of five people with spinal cord injury (SCI) report chronic pain. In general this chronic pain is refractory to conventional treatments. Exercise programs designed to alleviate shoulder pain, a particular subtype of nociceptive pain after SCI, have the strongest evidence for effectiveness. There is weak evidence that long term aerobic exercise can reduce chronic pain intensity in persons with SCI. The two purported mechanisms related to the amelioration of pain by exercise are enhanced descending inhibitory activity and reduced excitatory synaptic transmission, however experimental support for these mechanisms is meager. Finally there seems to be an association between exercise, pain, and mood states which may be related to common mechanisms and requires further study.