National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) Practice Exam

Chronic pain often leads to muscle atrophy, which is the reduction in muscle mass and strength. This occurs because prolonged pain can result in decreased movement and activity levels, leading to disuse of the affected muscles. When muscles are not used regularly, the body begins to break down muscle proteins, leading to a reduction in muscle size and function. This atrophy can also be exacerbated by the body's natural stress response to pain, which may lead to alterations in muscle metabolism and further detriment to muscle tissue.

In contrast, increased flexibility is not typically associated with chronic pain, as chronic pain often results in stiffness and decreased range of motion. Increased contractility refers to the ability of muscles to contract more forcefully, which is usually not a result of chronic pain but rather the opposite, as pain can inhibit muscle function. Hypertrophy, the increase in muscle size, would not occur in the presence of chronic pain; instead, muscles may weaken and shrink due to the lack of use and the negative impacts of pain.