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Evaluation of Swimming Exercise in Combination with non‐Steroidal Anti‐Inflammatory Drugs on Inflammatory Nociception in Rats

Pain is a growing health problem with increasing prevalence and burden worldwide. Major approaches for pain control include pharmacological and non‐pharmacological interventions. Pharmacological treatment is achieved by the use of analgesics, such as non‐steroidal anti‐inflammatory drugs (NSAIDs) and opioids. However, these medications are usually accompanied with many side effects upon prolonged use. Physical exercise is an example of non‐pharmacological interventions for pain control. In this study, we examined the effect of one of the most commonly prescribed NSAIDs, ibuprofen, on nociception threshold, with or without swimming exercise in rats. Two swimming protocols were used; Prophylactic group and treatment group. Nociception was induced by the intraplantar injection of Complete Freund's Adjuvant (CFA). Nociception threshold was measured using von Frey filaments in an up‐down protocol. The goal of this study was to determine the effect of swimming exercise on nociception threshold and ibuprofen‐induced antinociception in inflammatory pain rat model. We hypothesized that swimming exercise will enhance the ibuprofen‐induced antinociception in rats. Ibuprofen produced an antinociception effect only at the highest dose (32 mg/kg), with a duration that lasted for 17 days. A dose of 32 mg/kg ibuprofen produced significant increase in pain threshold in swimming treatment and prophylactic swimming groups when compared to ibuprofen alone group. Moreover, Ibuprofen produced significant antinociception after 10 mg/kg drug dose compared to vehicle in the prophylactic swimming group only. The duration of mechanical allodynia after CA injection was decreased in both swimming groups to 7 days only. In conclusion, the combination of ibuprofen and swimming exercise was shown to be effective in controlling nociception in a rat inflammatory pain model. The combination of exercise and ibuprofen could be suggested as an effective intervention to help control chronic pain. In addition, prophylactic swimming can increase the potency of analgesic medications, by lowering the administered drug dose, and thus, lowering the risk for ibuprofen‐induced side effects.