Background & Aims

The relationship between physical exercise and chronic pain has been contemplated for a long time. In theory, regular physical exercise would have a beneficial effect as an adjuvant in controlling chronic pain conditions. However, some patients with chronic painful conditions experience exacerbation of certain symptoms after activity, explaining why these individuals are unable to activate the endogenous descending pain inhibition pathway during exercise. Another strategy for these patients is pain modulation through cognitive manipulations, such as inducing relaxation through videos promoting the Autonomous Sensory Meridian Response (ASMR), which elicits an experience similar to that found in mindfulness and yoga. Therefore, the main objective of this present study is to compare the variation in pressure pain threshold (PPT) after a satisfying experience (ASMR) or the acute effect of physical exercise.

Methods

This was a two-phase cross-sectional study with a sample of 73 sedentary volunteers [34 asymptomatic and 39 chronic masticatory myofascial pain (CMMP) individuals according to DC-TMD]. The 2 groups were subdivided into two groups each based on the Conditioning Stimulus (CS): ASMR videos or treadmill exercise [CVi (N=19), CEx (n=15), CMMPVi (N=20), CMMPEx (N=19)]. On the first phase, the Short-form Survey (SF-36), visual analog scale (VAS), and conditioned pain modulation (CPM) test were performed. Also, ASMR group chose 3 pleasurable trigger videos, while individuals in the exercise group underwent the Conconi test to establish the ideal aerobic heart rate. After 1-week interval, PPT and VAS were measured before and after the CS with ASMR (15 minutes) or aerobic exercise (30 minutes). Participants in the ASMR group were asked about the reproduction of tingling, pleasurable sensation, and misophonia. Paired t-tests and Pearson’s correlation test were performed for statistical analysis.

Results

The sample mean age was 30.7 years (SD±9.85), and the initial VAS for the CMMPVi group was 5.09 (SD±2.52), while for the CMMPEx, 4.02 (SD±2.65). There were no statistically significant differences in the PPT variations when comparing the variations induced by ASMR or exercise with those induced by the pain stimulus through the sequential Conditioned Pain Modulation (CPM) protocol. However, there was a significant difference in pain perception before and after the intervention (CMPEx, p=0.043; CMPVi, p=0.004). In ASMR group, only 20.5% reported the sensation of tingling/shivering, but 84.6% reported that the experience was pleasurable. Misophonia was present in 41% of individuals, but it was not intense enough to interrupt the test. Additionally, there was no correlation between PPT and VAS with any of the SF-36 categories.

Conclusions

Despite the study’s limitations, the lack of a significant difference between groups and interventions may suggest that approaches exploring other evaluative dimensions of pain could influence the reduction of pain threshold and perception, even if it shows a lesser extent when compared to conventional conditioned pain modulation protocols. Further research is needed to elucidate the complexity of descending inhibitory mechanisms and assess the impact of these changes in daily clinical practice, aiming to incorporate new non-pharmacological control strategies for patients with chronic myofascial masticatory pain.

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Presenting Author

Tatiana da Fonte

Poster Authors

Tatiana da Fonte

MSc

University of São Paulo

Lead Author

E-mail

Maria Emilia Servin Berden

Bauru School of Dentistry, University of São Paulo

Lead Author

E-mail

Samilla Braga

Universidade de São Paulo

Lead Author

E-mail

Dyanne Medina Flores

Bauru School of Dentistry, Universidade de São Paulo

Lead Author

E-mail

Carolina Cunha

Sacred Heart University Center

Lead Author

E-mail

Paulo Conti

University of São Paulo

Lead Author

E-mail

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Muscle and Myofascial pain