Exercise Alleviates Pain Symptoms in Idiopathic Polyneuropathy

Researchers from Johns Hopkins University School of Medicine observed that among patients with idiopathic neuropathy, those who exercised regularly were less likely to experience severe pain symptoms according to study results published in the Journal of the Peripheral Nervous System.

Exercise is generally linked to improved outcomes in patients with certain peripheral neuropathies; there is limited data, however, regarding idiopathic peripheral neuropathies. Study researchers sought to analyze the relationship between regular exercise and polyneuropathy severity in patients with idiopathic polyneuropathy.

This study utilized cross-sectional data from the Peripheral Neuropathy Research Registry, which consists of a well-characterized patient cohort who have distal, symmetrical polyneuropathies treated at multiple centers. All patients who met inclusion criteria (N=324) in the database were assessed by a neurological exam, nerve conduction study evaluation, laboratory tests, and for their medical history. Since 2016, database patients were asked to respond to a 1-page exercise questionnaire, in which patients reported their exercise frequency, duration, and type during the previous 6 months.

Patients who had painful (n=239) and non-painful (n=85) neuropathy differed significantly for age (60.6±13.9 vs 66.7±12.5 years, respectively; P =.0004), gender (58.6% vs 77.7% men, respectively; P =.0016), and diastolic blood pressure (76.4±10.0 vs 73.3±9.3, respectively; P =.0144).

Patients were stratified by their exercise activity, in which 124 patients did not engage in exercise, 67 engaged in low activity, 67 engaged in intermediate levels of activity, and 66 engaged in high activity. These groups differed in levels of self-reported pain (P =.019) and painful neuropathy rates after adjusting for all covariates (P =.045).

Compared with patients who did not exercise, those who engaged in a high level of exercise activity level were less likely to have painful neuropathy (odds ratio [OR], 0.40; 95% CI, 0.18-0.86; P <.05) or to self-report pain (OR, 0.39; 95% CI, 0.19-0.81; P <.05).

Patients with intermediate levels of activity did not have decreased incidence of painful neuropathy compared with non-exercisers (OR, 0.59; 95% CI, 0.27-1.3). Patients with low activity levels did have decreased incidence of painful neuropathy compared with inactive patients (OR, 0.40; 95% CI, 0.19-0.86; P <.05).

Exercise did not have an effect on self-reported balance (P =.47), numbness (P =.49), or weakness (P =.53).

This study was limited by the self-reported retrospective design and potential recall bias. Additionally, there was missing data on patients’ reasons for not exercising, mechanisms by which exercise decreases probability of painful neuropathy, and exercise habits before and after patients’ pain began.

Study researchers concluded that their findings provide “evidence that exercise in those with IPN [idiopathic polyneuropathy] has a positive effect on reported pain but does not impact other self-reported measures like numbness or weakness” and suggest that “exercise should be considered a treatment option for patients with IPN, particularly those with painful neuropathy.”

Reference

Stewart S, Thomas S, Van Doormaal PTC, Höke A. Relation of Exercise and Pain in Patients with Idiopathic Distal Axonal Polyneuropathies. J Peripher Nerv Syst. Published online October 6, 2020. doi:10.1111/jns.12415