Knowledge is needed regarding mechanisms acting between physical activity (PA) and chronic pain. We investigated whether cold pain tolerance mediates an effect of leisure-time physical activity on the risk of chronic pain 7 to 8 years later using consecutive surveys of the population-based Tromsø Study. We included participants with information on baseline leisure-time PA (LTPA) and the level of cold pressor-assessed cold pain tolerance, who reported chronic pain status at follow-up as any of the following: chronic pain for ≥3 months, widespread chronic pain, moderate-to-severe chronic pain, or widespread moderate-to-severe chronic pain. We included 6834 participants (52% women; mean age, 55 years) in counterfactual mediation analyses. Prevalence decreased with severity, for example, 60% for chronic pain vs 5% for widespread moderate-to-severe chronic pain. People with one level higher LTPA rating (light to moderate or moderate to vigorous) at baseline had lower relative risk (RR) of 4 chronic pain states 7 to 8 years later. Total RR effect of a 1-level LTPA increase was 0.95 (0.91-1.00), that is, -5% decreased risk. Total effect RR for widespread chronic pain was 0.84 (0.73-0.97). Indirect effect for moderate-to-severe chronic pain was statistically significant at RR 0.993 (0.988-0.999); total effect RR was 0.91 (0.83-0.98). Statistically significantly mediated RR for widespread moderate-to-severe chronic pain was 0.988 (0.977-0.999); total effect RR was 0.77 (0.64-0.94). This shows small mediation of the effect of LTPA through pain tolerance on 2 moderate-to-severe chronic pain types. This suggests pain tolerance to be one possible mechanism through which PA modifies the risk of moderate-to-severe chronic pain types with and without widespread pain.

中文翻译：

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疼痛耐受性是否介导体力活动对普通人群慢性疼痛的影响？特罗姆瑟研究。

需要了解体力活动 (PA) 和慢性疼痛之间的作用机制。我们通过基于人群的特罗姆瑟研究的连续调查，调查了冷痛耐受性是否会介导休闲时间体力活动对 7 至 8 年后慢性疼痛风险的影响。我们纳入了具有基线休闲时间 PA (LTPA) 和冷加压评估的冷痛耐受水平信息的参与者，他们在随访时报告慢性疼痛状态为以下任何一种：慢性疼痛≥3 个月、广泛慢性疼痛疼痛、中度至重度慢性疼痛或广泛的中度至重度慢性疼痛。我们纳入了 6834 名参与者（52% 为女性；平均年龄 55 岁）进行反事实中介分析。患病率随严重程度而降低，例如，慢性疼痛的患病率为 60%，而广泛的中度至重度慢性疼痛的患病率为 5%。基线时 LTPA 评级（轻度至中度或中度至剧烈）高一级的人 7 至 8 年后出现 4 种慢性疼痛状态的相对风险 (RR) 较低。LTPA 增加 1 级的总 RR 效应为 0.95 (0.91-1.00)，即风险降低 -5%。广泛慢性疼痛的总效应 RR 为 0.84 (0.73-0.97)。对中度至重度慢性疼痛的间接影响具有统计学意义，RR 为 0.993 (0.988-0.999)；总效应 RR 为 0.91 (0.83-0.98)。广泛的中度至重度慢性疼痛的统计学显着介导 RR 为 0.988 (0.977-0.999)；总效应 RR 为 0.77 (0.64-0.94)。这表明 LTPA 通过疼痛耐受性对 2 种中度至重度慢性疼痛类型的影响有小中介作用。这表明疼痛耐受性是一种可能的机制，通过该机制，PA 可以改变伴有或不伴有广泛疼痛的中度至重度慢性疼痛类型的风险。