317: Pain Relief Occurs with Offset Exercise Across the Lifespan

Topic: Clinical Science
Subtopic: Non-specific to any diagnosis, Non-pharmacological treatments, Physiotherapy (e.g. exercise, rehab), Quantitative Sensory testing (static and dynamic, e.g., HPT, PPT, CPM, TSP, offset analgesia)

Background and Aims: Pain during exercise has been reported across exercise type and age group, negatively impacting exercise behaviors [1,2]. Creative activity interventions are needed to reduce exercise barriers, namely pain with movement. The primary objective of this study was to translate offset analgesia to an exercise task to reduce pain and improve feelings towards exercise (affective valence) across the lifespan. To enhance the real-world applicability of these findings, data collection included two local retirement communities in addition to the academic lab setting.

Methods: One hundred eighteen adults (50 young: 22.7±4.3yrs, 43 community-dwelling: 70.0±7.8yrs, 25 retirement community: 81.8±5.9yrs) completed one leg strengthening exercise task that paralleled thermal offset analgesia [3] but modulated exercise intensity, not temperature. Participants held an isometric knee extension exercise (25% maximal voluntary contraction [MVC] force) until moderate pain (5/10). Then, intensity increased (50% MVC) for 10s before returning to the initial intensity for 10s. Pain was reported 5, 15, 20, and 25s after moderate pain and offset analgesia was calculated [3]: (20s pain/15s pain)*100. Affective valence was rated using the Feeling Scale [4].

Results: Exercise offset analgesia occurred (63.3%±23.0). Pain was significantly lower after the increase in exercise intensity (4.3±1.5) compared to before (6.9±1.1; p<.001) at the same intensity (25% MVC). There was no significant age effect. Feelings improved following the exercise offset (0.49±2.2 at worst to 2.1±1.9 at end; p<.001) which was similar across age (p>0.05). Affective valence at the end of the exercise task (2.1±1.9) was negatively correlated with pain reported at that time point (4.3±1.5; r= -0.22, p=0.03); participants with lower pain at the end of exercise reported more positive feelings towards exercise.

Conclusions: Offset analgesia can be translated into exercise prescription to reduce pain and improve feelings during exercise across the lifespan. Ending exercise with less pain and improved feelings has the potential to improve long-term exercise tolerance and adherence, thereby improving overall health and function.

References: 1. Cohen-Mansfield, J., Marx, M. S., & Guralnik, J. M. (2003). Motivators and Barriers to Exercise in an Older Community-Dwelling Population. https://doi.org/10.1123/japa.11.2.242
2. Dannecker, E. A., & Koltyn, K. F. (2014). Pain During and Within Hours After Exercise in Healthy Adults. Sports Medicine, 44(7), 921–942. https://doi.org/10.1007/s40279-014-0172-z
3. Harris, S., Sterling, M., Farrell, S. F., Pedler, A., & Smith, A. D. (2018). The influence of isometric exercise on endogenous pain modulation: Comparing exercise-induced hypoalgesia and offset analgesia in young, active adults. Scandinavian Journal of Pain, 18(3), 513–523. https://doi.org/10.1515/sjpain-2017-0177
4. Hardy, C. J., & Rejeski, W. J. (1989). Not What, But How One Feels: The Measurement of Affect During Exercise. Journal of Sport & Exercise Psychology, 11(3), 304–317. https://doi.org/10.1123/jsep.11.3.304

Presenting Author: Marie Hoeger Bement
Submitting Author: Savannah Gutsch

Senior Author: Marie Hoeger Bement

IASP 2026 Global Year theme of Neuropathic Pain: No

• Caroline E. Donahue: NA - Marquette University
• Robert T. McChesney: NA - Marquette University
• Teresa N. Brinkmann: NA - Marquette University
• Marie Hoeger Bement: PT, PhD - Marquette University