Research Summary

Academy Title:andersen2012-painphysician
Research Article: Central adaptation of pain perception in response to rehabilitation of musculoskeletal pain: randomized controlled trial

Chronic neck/shoulder pain is common in office workers. Chronic musculoskeletal pain is thought to be mediated by the central nervous system (CNS) through a process known as “central sensitization”, which is characterized by an increased sensitivity to pain and pressure. Central sensitization is often quantified with a pain-pressure test (PPT). During the PPT, pressure is applied to a tender point within a muscle and measured. Lower PPTs are associated with central sensitization of pain, indicated by a lower threshold for causing muscular pain.

Professor Lars Andersen and his colleagues in Copenhagen, Denmark at the National Research Center for the Working Environment, have studied the effects of Thera-Band® exercises on office workers with chronic neck and shoulder pain. They have shown that a shoulder lateral raise exercise with Thera-Band tubing performed for as little as 2 minutes a day significantly reduces chronic neck/shoulder pain.

thera-band-tubing-lateral-raise-shoulder-standing-femaleDr. Andersen and his colleagues recently published another randomized, controlled trial (the highest level of evidence) in the journal, Pain Physician involving 198 office workers with chronic musculoskeletal pain. The subjects were randomly assigned to 1 of 3 groups: 2-minute exercise, 12-minute exercise, or control. The exercise group performed a shoulder lateral raise with Thera-Band tubing once a day, 5 times per week for 10 weeks. The researchers assessed PPT in both the painful trapezius muscle and in a remote leg muscle (tibialis anterior). They wanted to see if the exercise program changed the PPT in both the neck/shoulder region and in the distant leg muscles. A change in the PPT of a distant non-painful muscle may indicate a central adaptation of chronic pain from a simple Thera-Band exercise; in other words, the researchers wanted to see if the CNS was affected by the exercise in chronic pain patients.

After the 10-week program, the researchers found both the target neck/shoulder muscle (trapezius) and distal reference muscle (tibialis anterior) significantly increased their PPT, indicating an improvement in pain perception. They suggested the exercise had a positive effect on the CNS on reducing chronic musculoskeletal pain. Interestingly, the magnitude of improvement in PPT was similar in both exercise groups (2- and 12-minute groups).

Dr. Andersen and his colleagues concluded that a single, 2-minute set of lateral raise exercise with Thera-Band tubing can change pain perception, providing “evidence of central adaptation of pain perception in response to rehabilitation of musculoskeletal pain.” Because chronic musculoskeletal pain is mediated by the CNS, these findings are significant in that they suggest exercise has both a local and global influence on the structure and function of the musculoskeletal and nervous systems.

REFERENCE: Andersen LL, et al. Central adaptation of pain perception in response to rehabilitation of musculoskeletal pain: randomized controlled trial. 2012. Pain Physician. 15:385-394. Available online at;15;385-394.pdf

Disclosure: Thera-Band Academy provided the tubing used in this study.

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