Recognizing Rumination and Examining the Relationship with Pain Experience and Physical Activity: A Traditional Review

Abstract

In recent years, it has been frequently emphasized that musculoskeletal pain should be addressed with a biopsychosocial approach centered on exercise interventions. Negative pain beliefs such as pain catastrophizing can lead to kinesiophobia and thus to physical inactivity. Physical inactivity can lead to chronic pain and increased fear, leading to a vicious circle. Along with magnification and helplessness, rumination is among the three sub-dimensions of pain catastrophizing. Rumination, defined as "ruminating" and "repeatedly reviewing" in the dictionary, and it is well-known that rumination negatively affects physical health, and rumination levels are high in individuals with chronic conditions such as chronic pain, cardiovascular disease, and obesity. Research showed that rumination is positively associated with pain and negatively associated with physical activity. An increase in the rumination level may cause increases in pain intensity, emotional distress, and negative attitude towards pain and may also result in reduced physical activity levels. Structured exercise programs may have beneficial consequences for musculoskeletal pain as well as the negative effects of rumination. However, depression often accompanies increased rumination and may pose a risk for exercise adherence by reducing the physical activity pleasure. This review aimed to overwiev the relationship of rumination with pain and physical activity. In conclusion, physical activity programs aimed to reduce rumination may include aerobic activities, mindfulness exercises, stretching, and strengthening exercises. It can be beneficial to perform the exercises three times a week for 30-60 minutes.

Keywords

• exercise
• kinesiophobia
• pain
• physical activity
• rumination