941 - Movement Without Relief? Exploring The Relationship Between Pain and Physical Activity in Rural Kenya

Although regular exercise can prevent and manage noncommunicable diseases, the physical activity paradox suggests that certain types of physical activity (PA), such as occupational manual labor, may contribute to adverse health outcomes, including chronic pain. This relationship is relevant in rural areas with common manual labor and limited healthcare access. This study examines how PA patterns relate to musculoskeletal pain among adults in rural Kenya.


Design:

This cross-sectional study was conducted at a rural outreach clinic in Kenya after IRB approval. Ten adult patients met inclusion criteria and completed surveys assessing their musculoskeletal pain (severity, duration, and location) and PA levels (daily and weekly volume of vigorous activity, moderate activity, walking, and sitting). One incomplete survey was excluded. Primary analyses were conducted at the individual level (n = 9) using aggregated pain severity and duration values. Exploratory analyses used pain-report level data (12 pain reports reflecting participants who reported multiple pain sites). Analyses were performed with Spearman rank correlations (ρ).

Results: At the individual level, maximal pain duration was negatively correlated with daily sitting time (ρ = -0.69, p = .04). No other significant associations were observed. The pain-report-level analysis revealed that lower extremity pain was positively correlated to weekly moderate PA (ρ = .677, p = .016). Additionally, pain duration was positively correlated with daily moderate PA (ρ = 0.67, p = 0.018) and negatively with daily sitting (ρ = -0.76, p = 0.004).

Conclusions:

In this small rural cohort, shorter pain duration was associated with increased sedentary behavior. Exploratory analysis at the pain-report level suggested moderate physical activity, largely through manual labor, was associated with longer pain duration and lower extremity pain. These findings illustrate the complex relationship between PA and pain, suggesting a need for tailored pain management strategies and context-specific physical activity guidelines that account for rural labor demands.