Abstract

In the world of athletics, the role of pain is complex. While pain-relieving medications like ibuprofen are commonly used, research on their effects on athletes remains limited in number and quality. Additionally, the influence of the placebo effect in sports remains unclear. Our study aimed to compare the impact of ibuprofen and placebos on conditioned pain modulation in athletes. We conducted a semi-randomized controlled trial involving 60 male and 60 female varsity athletes across ten sports disciplines. Participants underwent two visits and were randomly assigned to one of three groups: ibuprofen, placebo, or control. We assessed subjective pain using a numerical scale before, during, and after a cold pressor test (CPT). Conditioned pain modulation was measured via pain pressure threshold measurements before and after the cold pressor test. We monitored cardiovascular variables during-CPT which may serve as a more objective measure of pain. Surprisingly, neither the ibuprofen nor the placebo led to a significant reduction in pain during the CPT. All athletes experienced heightened pain perception, increased blood pressure, and elevated heart rate during-CPT, followed by a return to baseline post-CPT. All athletes exhibited an improved pain pressure threshold after the CPT, indicating conditioned pain modulation. Male and female athletes experienced the same pain during the CPT, however, when pain was measured a different way, via pressure algometry, males could tolerate more pressure before it became painful. This makes it more complicated to distinguish which sex feels more pain, and sex differences in pain perception require further investigation.