Evidence map›Paper›PMID 40099368›Full record

Trial reportArthritis care & research2025

Association of Pain During Exercise With Exercise-Induced Hypoalgesia in People With Knee Osteoarthritis.

Soyoung Lee, Tuhina Neogi, Benjamin M Senderling, S Reza Jafarzadeh, Mary Gheller, Pirinka G Tuttle, Charmaine Demanuele, Lars Viktrup, Paul Wacnik, Deepak Kumar

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Arthritis care & research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Soyoung LeeBoston University, Boston, Massachusetts.
Tuhina NeogiBoston University, Boston, Massachusetts.ORCID 0000-0002-9515-1711
Benjamin M SenderlingBoston University, Boston, Massachusetts.
S Reza JafarzadehBoston University, Boston, Massachusetts.ORCID 0000-0002-1099-9175
Mary GhellerBoston University, Boston, Massachusetts.
Pirinka G TuttlePfizer Inc, Cambridge, Massachusetts.
Charmaine DemanuelePfizer Inc, Cambridge, Massachusetts.
Lars ViktrupEli Lilly and Company, Indianapolis, Indiana.
Paul WacnikPfizer Inc, Cambridge, Massachusetts.
Deepak KumarBoston University, Boston, Massachusetts.ORCID 0000-0003-1728-484X

Funding

Research and Evaluation Support Core Unit (RESCU Core)P30AR072571 · NIAMS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI Michael Paul Lavalley · 2019 to 2026
$6.9M
PRROPS: Pathways of Risk and Resilience for Overlapping Pain and SensitizationR01NS121419 · NINDS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI Emelia J. Benjamin, ROBERT R EDWARDS · 2021 to 2026
$3.7M
CAPSITE: Community Assessment of Pain and Sensitization in the ElderlyR01AG066010 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI BENJAMIN, EMELIA J., EDWARDS, ROBERT R · 2020 to 2025
$3.3M
Pain in community-based older African American Adults: The Jackson Heart StudyR01AG066914 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI BENJAMIN, EMELIA J., EDWARDS, ROBERT R · 2020 to 2024
$3.2M
The Role of Urate in Knee Osteoarthritis-Related Inflammation, Pathology and PainK24AR070892 · NIAMS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI TUHINA NEOGI · 2017 to 2026
$1.1M
Mind Your Walk Intervention for Community-Based Management of Knee OA: A Feasibility StudyK01AR069720 · NIAMS · BOSTON UNIVERSITY (CHARLES RIVER CAMPUS) · PI KUMAR, DEEPAK · 2017 to 2021
$676k
Eli Lilly and CompanyNIAMS NIH HHS K01 AR069720NIAMS NIH HHS K01AR069720NIAMS NIH HHS K24 AR070892NIAMS NIH HHS P30 AR072571NIA NIH HHS R01 AG066010NIA NIH HHS R01 AG066914NINDS NIH HHS R01 NS121419Pfizer
6 · The paper itself

Abstract

objectiveA paradoxical relationship between pain during exercise and the hypoalgesic effect of exercise has not been studied well in the knee osteoarthritis (OA) population. We sought to investigate the relation of pain evoked during exercise to exercise-induced hypoalgesia (EIH) and to determine if the efficiency of conditioned pain modulation (CPM), a proxy of the descending pain inhibitory system, mediates this relationship in people with knee OA.

methodsWe used baseline data from two clinical trials for people with symptomatic knee OA (n = 68). The maximum pain rating (0-10) during a series of knee exercises was defined as the outcome. EIH was assessed as an increase (ie, improvement) in the pressure pain threshold (PPT) after a bout of exercises. Efficient CPM was defined as an increase (ie, improvement) in PPT after a painful conditioning stimulus (forearm ischemia). We performed a causal mediation analysis to examine the association between pain during exercise and EIH as well as the mediating role of CPM efficiency on the relation of pain during exercise with EIH.

resultsPeople with knee OA who had at least a one-unit increase in pain with exercise were 43% more likely (odds ratio [OR] 1.43, 95% confidence interval [CI] 1.05-1.94) to experience subsequent EIH than those without pain increase. The efficiency of CPM did not mediate the relationship between pain during exercise and EIH (OR 1.00, 95% CI 0.96-1.04).

conclusionOur finding suggests that some amount of discomfort or pain during exercise may have beneficial analgesic effects; however, this is not likely via activation of the descending pain inhibitory system.

Indexed as

ArthralgiaExerciseExercise TherapyOsteoarthritis, KneePain ThresholdAgedFemaleHumansMaleMiddle AgedPain Measurement

Identifiers

PMID40099368
PMCPMC12213136

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.