Association between the plasma levels of mediators of inflammation with pain and disability in the elderly with acute low back pain: Data from the Back Complaints in the Elders (BACE)-Brazil study.
Spine (Phila Pa 1976). 2015 Oct 15;
Authors: Queiroz BZ, Pereira DS, Lopes RA, Felício DC, Silva JP, Rosa NM, Dias JM, Dias RC, Lustosa LP, Pereira LS
STUDY DESIGN: Cross-sectional study with subsample of elderly women with acute low back pain (LBP), from Back Complaints in the Elders-Brazil (BACE-Brazil) OBJECTIVE.: To investigate the association between plasma levels of mediators of inflammation (interleukin-1 beta (IL-1?), IL-6, tumor necrosis factor alpha (TNF-?), and soluble TNF receptor 1 (sTNF-R1)) with pain and disability experienced by elderly women with acute LBP.
SUMMARY OF BACKGROUND DATA: Among the elderly, LBP is a complaint of great importance and can lead to disability. Inflammatory cytokines are elevated in painful conditions, and may promote pain.
METHODS: We included 155 community-dwelling elderly women (age ? 65 years), who presented with a new (acute) episode of LBP. Enzyme-linked immunosorbent assays were used to measure TNF-?, sTNF-R1, IL-1?, and IL-6. Disability was assessed using the Roland Morris Disability Questionnaire; pain was assessed using the McGill Pain Questionnaire. Linear regression models were fit with each pain and disability outcome as dependent variables: Present Pain Intensity; Qualities of pain; Severity of pain in the last week; LBP frequency and disability.
RESULTS: Depressive symptoms and IL-6 were associated and explained 20.9% of “Qualities of pain” variability. TNF-?, sTNFR1, education, body mass index, and depressive symptoms explained 8.4% of “Severity of pain in the past week” variability. TNF-?, education, BMI, depressive symptoms, Present Pain Intensity, Qualities of pain, and LBP frequency explained 48.6% of “Disability”. No associations between inflammatory cytokines and “Present Pain Intensity” and “LBP frequency” were found.
CONCLUSIONS: Our results demonstrate associations between inflammatory markers (TNF-? and sTNFR1) and pain severity, IL-6 was associated with the qualities of pain, and TNF-? was also associated with disability. These inflammatory mediators represent new markers to be considered in the assessment and treatment of elderly patients with LBP.
LEVEL OF EVIDENCE: 5.
PMID: 26571172 [PubMed – as supplied by publisher]