運動與慢性疼痛

Exercise as Non-Pharmacological Treatment in Patients with Chronic Pain

李耀泰(Yiu-Tai Li) ； 陳福民(Fu-Min Chen) ； 郭宗正(Tsung-Cheng Kuo)

《南臺灣醫學雜誌》 17卷1期 (2021/06) Pp. 1-6

https://doi.org/10.6726/MJST.202106_17(1).0001

摘要

運用運動來治療慢性疼痛有增加的趨勢，如退化性關節炎、風濕性關節炎、全身發炎性風濕疾病、結締組織疾病、疱疹後神經痛、末梢神經病變、慢性頭痛、纖維肌痛症、慢性下背痛等，這些疼痛常伴隨生理功能欠佳，包括活動受到限制、憂鬱、睡眠品質差等，需以藥物或合併非藥物（如有氧、阻力、伸展、平衡等運動）來治療。慢性疼痛主要機轉在慢性的低度發炎，過去研究證實，運動能調變發炎的過程。至於運動能抗發炎的機轉，與減少內臟脂肪、降低血液循環中前驅發炎的單核球、增加血液循環的T細胞調節有關，所以近期的研究均支持運動有助於舒緩慢性疼痛。

關鍵字

運動 ； 慢性疼痛 ； 發炎 ； 纖維肌痛症

並列摘要

Exercise increasingly is prescribed to treat many chronic pain, disorders including osteoarthritis, rheumatoid arthritis, systemic inflammatory rheumatic disease, connective tissue disease, post-herpetic neuralgia, peripheral neuropathy, chronic neck pain, fibromyalgia and chronic low back pain. These disorders are frequently associated with poor physical function, mobility limitation, depression, anxiety and sleep disturbance, and are treated alone or in combination by pharmacologic and nonpharmacologic approaches, such as exercise(aerobic and resistance exercise, flexibility and balance exercise). Chronic low-grade inflammation is a key underlying mechanism in patients with chronic pain, and previous studies have shown that exercise can modulate the inflammatory process. The possible mechanisms of exercise anti-inflammatory effects include reduction in visceral fat mass, reduction in the circulating numbers of pro-inflammatory monocytes and an increase in the circulating numbers of regulatory T cells. The current studies provide evidence the exercise is more appropiate in the first-line treatment of chronic pain.

並列關鍵字

exercise ； chronic pain ； inflammation ； fibromyalgia