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Cold pain tolerance mediates the effect of physical activity on lowering risks of moderate-to-severe chronic pain in the general population
  1. Jiale Hu1,
  2. Jiamin Kang2
  1. 1Virginia Commonwealth University, Richmond, Virginia, USA
  2. 2School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
  1. Correspondence to Professor Jiale Hu, Virginia Commonwealth University, Richmond, Virginia, USA; jhu4{at}; Ms Jiamin Kang, No. 209 Tongshan Road, Jiangsu, China; jmKang128{at}

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Commentary on: Årnes AP, Fjeld MK, Stigum H, Nielsen CS, Stubhaug A, Johansen A, Hopstock LA, Morseth B, Wilsgaard T, Steingrímsdóttir ÓA. Does pain tolerance mediate the effect of physical activity on chronic pain in the general population? The Tromsø Study. Pain. 2024 Mar 5. doi: 10.1097/j.pain.0000000000003209. Epub ahead of print. PMID: 38442413.

Implications for practice and research

  • Further studies are warranted to investigate the pain sensitivity-related mechanisms of the risk-reducing effects of physical activity on moderate-to-severe chronic pain with other potential indirect pathways, such as impacts on inflammatory markers or psychosocial and behavioural components.

  • Integrating tailored physical activity programmes into chronic pain management protocols is strongly recommended to enhance patient outcomes.


Chronic pain, defined as pain persisting for more than 3 months, significantly impacts the quality of life and contributes to substantial healthcare costs globally. Despite its prevalence, …

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  • JH and JK are joint first authors.

  • X @garyhu11

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.