title: Pain variability in fibromyalgia is related to activity and rest: role of peripheral tissue impulse input.
abstract: Because fibromyalgia (FM) patients frequently report activity-dependent deep tissue pains, impulse input from painful body regions may be relevant for their musculoskeletal complaints. In addition, peripheral impulse input may induce and maintain thermal and mechanical hyperalgesia of FM patients. If so, activity and rest may alternately enhance and diminish intensity of FM pain. However, the effects of exercise on pain are ambiguous in studies of FM. Whereas exercise-only studies demonstrated increased pain and hyperalgesia during and after physical activity, some exercise studies that included rest periods resulted in decreased FM pain and increased function. To further clarify these effects, we examined the effects of alternating exercise with rest on clinical pain and thermal/mechanical hyperalgesia of 34 FM patients and 36 age-matched healthy controls (NC). Using an ergometer, all subjects performed arm exercise to exhaustion twice alternating with 15-minute rest periods. Although strenuous muscle activity was reported as painful by most FM subjects, overall clinical pain consistently decreased during the rest periods. Additionally, FM subjects' pain sensitivity to mechanical pressure decreased after each exercise and rest session.
  
  
  CONCLUSIONS
  Alternating strenuous exercise with brief rest periods not only decreased overall clinical pain of FM subjects but also their mechanical hyperalgesia. No prolonged worsening of overall FM pain and hyperalgesia occurred despite vigorous muscle activity. Our findings contribute further evidence that FM pain and hyperalgesia are at least partially maintained by muscle impulse input, and that some types of exercises may be beneficial for FM.
  
  
  CONCLUSIONS
  FM is a pain-amplification syndrome that depends at least in part on peripheral tissue impulse input. Whereas muscle activity increased overall pain, short rest periods produced analgesic effects.
authors.affiliation: Department of Medicine, University of Florida, Gainesville, Florida, USA. staudr@ufl.edu
authors.forename: Roland
authors.initials: R
authors.lastname: Staud
authors.forename: Michael E
authors.initials: ME
authors.lastname: Robinson
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Weyl
authors.forename: Donald D
authors.initials: DD
authors.lastname: Price
mesh_terms: D000328:Adult; D015444:Exercise / Q000502:physiology*; D005260:Female; D005356:Fibromyalgia / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D006930:Hyperalgesia / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology; D010146:Pain / Q000209:etiology* / Q000503:physiopathology; D017288:Pain Threshold / Q000502:physiology; D012146:Rest / Q000502:physiology*
references.citation: Arthritis Rheum. 1988 Sep;31(9):1135-41
references.pmid: 3048273
references.citation: Joint Bone Spine. 2002 May;69(3):293-9
references.pmid: 12102276
references.citation: Arthritis Care Res. 1994 Dec;7(4):221-5
references.pmid: 7734481
references.citation: Sports Med. 1992 Jan;13(1):25-36
references.pmid: 1553453
references.citation: Arthritis Rheum. 1989 Apr;32(4):454-60
references.pmid: 2706029
references.citation: J Rheumatol. 2008 Jun;35(6):1130-44
references.pmid: 18464301
references.citation: Pain. 1992 Nov;51(2):175-194
references.pmid: 1484715
references.citation: Cochrane Database Syst Rev. 2007 Oct 17;(4):CD003786
references.pmid: 17943797
references.citation: Pain. 1985 Jul;22(3):261-269
references.pmid: 2993984
references.citation: Scand J Rheumatol. 1996;25(2):77-86
references.pmid: 8614771
references.citation: Brain Res. 1985 Dec 23;360(1-2):33-40
references.pmid: 3000534
references.citation: Neuroreport. 2003 Dec 2;14(17):2209-11
references.pmid: 14625449
references.citation: Eur J Appl Physiol Occup Physiol. 1995;70(3):195-9
references.pmid: 7607192
references.citation: J Pain. 2007 Nov;8(11):893-901
references.pmid: 17681887
references.citation: Pharmacol Biochem Behav. 1997 Sep;58(1):109-17
references.pmid: 9264078
references.citation: J Rheumatol. 1996 Jun;23(6):1050-3
references.pmid: 8782139
references.citation: Pain. 1984 May;19(1):13-25
references.pmid: 6330643
references.citation: Arthritis Rheum. 2006 Apr;54(4):1334-9
references.pmid: 16575859
references.citation: Arthritis Rheum. 1990 Feb;33(2):160-72
references.pmid: 2306288
references.citation: Pain. 1998 May;76(1-2):71-81
references.pmid: 9696460
references.citation: Pain. 2009 Sep;145(1-2):96-104
references.pmid: 19540671
references.citation: J Pharmacol Exp Ther. 1996 Jul;278(1):125-35
references.pmid: 8764343
references.citation: Arthritis Rheum. 2003 May;48(5):1420-9
references.pmid: 12746916
references.citation: Cochrane Database Syst Rev. 2015 Apr 09;(4):CD001980
references.pmid: 25856658
references.citation: Eur J Pain. 2008 Nov;12(8):1078-89
references.pmid: 18367419
references.citation: Neuroimage. 2009 Sep;47(3):995-1001
references.pmid: 19375508
references.citation: J Rheumatol. 1998 Jan;25(1):152-5
references.pmid: 9458220
references.citation: Clin Rheumatol. 2000;19(4):253-7
references.pmid: 10941802
references.citation: Pain. 1986 Jan;24(1):93-116
references.pmid: 3951883
references.citation: J Rheumatol. 2002 Dec;29(12):2620-7
references.pmid: 12465163
references.citation: Life Sci. 1982 Sep 20-27;31(12-13):1241-4
references.pmid: 7144433
references.citation: Pain. 1992 May;49(2):273-278
references.pmid: 1376888
references.citation: J Sports Med Phys Fitness. 1994 Sep;34(3):203-16
references.pmid: 7830383
references.citation: Arch Gen Psychiatry. 1973 Sep;29(3):319-25
references.pmid: 4724141
references.citation: J Rheumatol. 2002 Mar;29(3):582-7
references.pmid: 11908577
references.citation: Baillieres Clin Endocrinol Metab. 1987 May;1(2):415-37
references.pmid: 3327499
references.citation: Ann Rheum Dis. 2001 Jan;60(1):21-6
references.pmid: 11114277
references.citation: Acta Anaesthesiol Belg. 2002;53(3):203-12
references.pmid: 12461830
references.citation: CNS Spectr. 2008 Mar;13(3 Suppl 5):12-7
references.pmid: 18323768
references.citation: Brain Res. 2003 Oct 17;987(2):214-22
references.pmid: 14499966
references.citation: Clin Exp Rheumatol. 1995 Jul-Aug;13(4):477-82
references.pmid: 7586780
references.citation: J Consult Clin Psychol. 1981 Apr;49(2):193-211
references.pmid: 7217485
references.citation: Ann Behav Med. 1999 Spring;21(2):180-91
references.pmid: 10499139
references.citation: Sports Med. 2000 Feb;29(2):85-98
references.pmid: 10701712
references.citation: Rheum Dis Clin North Am. 2002 May;28(2):419-36, x-xi
references.pmid: 12122928
references.citation: Arthritis Rheum. 2001 Dec;45(6):519-29
references.pmid: 11762686
references.citation: Biofeedback Self Regul. 1977 Sep;2(3):221-39
references.pmid: 922057
references.citation: Arthritis Care Res. 1989 Dec;2(4):165-7
references.pmid: 2487722
references.citation: Pain. 1994 Jun;57(3):265-275
references.pmid: 7936706