400 Section - Physical activity and central pain sensitivity in rheumatoid arthritis: A longitudinal study

Wednesday, May 20, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

AI

Aya Abd Elkhabir Ibrahim, MS

Registrar rehabilitation medicine and PhD researcher
Nottingham University Hospitals NHS trust and Arthritis Research UK Pain Centre, University of Nottingham
NOTTINGHAM, England, United Kingdom

Co-Author/Coautor(s)

SL

Stephanie L. Smith, PhD

Senior research fellow
Arthritis Research UK Pain Centre and Nottingham NIHR Biomedical Research Centre, University of Nottingham
Nottingham, England, United Kingdom
VG

Vasileios Georgopoulos, PhD

Postdoctoral research fellow
Arthritis Research UK Pain Centre and Nottingham NIHR Biomedical Research Centre, University of Nottingham
Nottingham, England, United Kingdom
DW

David A. Walsh, PhD

Professor (Retired recently)
Arthritis Research UK Pain Centre and Nottingham NIHR Biomedical Research Centre, University of Nottingham
Nottingham, England, United Kingdom
DM

Daniel F McWilliams, PhD

Senior research fellow
Arthritis Research UK Pain Centre and Nottingham NIHR Biomedical Research Centre, University of Nottingham
Nottingham, England, United Kingdom

Objectives : Rheumatoid arthritis (RA) is a chronic condition where pain often persists despite controlled inflammation. This is frequently linked to central pain sensitivity, reflecting altered central nervous system processing that impacts pain perception. Physical activity is routinely encouraged for its health benefits; however, its relationship with centrally mediated pain sensitivity is unclear, and evidence to guide rehabilitation practice is limited. This study investigates whether self-reported physical activity levels predict changes in pain sensitivity over time in RA.

Design: Participants with RA from the Central Aspects of Pain in RA cohort completed the International Physical Activity Questionnaire to categorise physical activity as Low, Moderate, or High. Pain sensitivity was assessed using the Central Aspects of Pain (CAP) questionnaire. Pain severity was the sum of three 0–10 numerical rating scales. Spearman’s correlations and multivariable linear regressions explored associations at baseline and over 3 months.

Results: At baseline, 92 participants (median age 65 [IQR 59-72], 78% female) were included; 54% had low physical activity, and the median CAP score was 8 (IQR 7-11). At 3-month follow-up (n = 64), 49% were classified as Low, 34% Moderate, and 17% High physical activity. In bivariate analysis, higher baseline physical activity was correlated with lower baseline CAP scores (rho=-0.24, p=0.019). However, in multivariable analyses, higher baseline physical activity predicted increased CAP scores at 3 months (β = 0.26, p = 0.04), indicating lower pain sensitivity at baseline but higher pain sensitivity at follow-up.

Conclusion: Higher levels of physical activity were associated with increased pain sensitivity over time. Physical activity health benefits are well established; however, its effects on centrally mediated pain features may vary, highlighting the need to further explore individualised and structured approaches in future research.