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Inflammatory Mediators and Pain in the First Year After Acute Episode of Low-Back Pain in Elderly Women: Longitudinal Data from Back Complaints in the Elders-Brazil.

Queiroz, Bárbara Zille PhD; Pereira, Daniele Sirineu PhD; Rosa, Nayza Maciel de Britto PhD; Lopes, Renata Antunes PhD; Andrade, André Gustavo Pereira PhD; Felício, Diogo Carvalho PhD; Jardim, Renata Muniz Freire Vinhal Siqueira MD; Leopoldino, Amanda Aparecida Oliveira MSc; Silva, Juscélio Pereira PhD; Pereira, Leani Souza Máximo PhD
American Journal of Physical Medicine & Rehabilitation: Post Author Corrections: November 24, 2016
doi: 10.1097/PHM.0000000000000661
Original Research Article: PDF Only

Objective: The aims of this study were to determine the course of plasma levels of inflammatory mediators (interleukin 6 [IL-6], tumor necrosis factor [alpha] [TNF-[alpha]], soluble TNF receptor 1 [sTNF-R1]) and the severity of low-back pain (LBP) over 6 to 12 months after an acute episode of LBP in elderly women and to establish an association between inflammatory mediators and LBP recovery.

Design: This was a longitudinal study of a subsample (155 elderly women with acute LBP, aged >=65 years) of the international Back Complaints in the Elders cohort study. Plasma levels of IL-6, TNF-[alpha], and sTNF-R1 were measured using enzyme-linked immunosorbent assays and pain severity using the numerical pain scale.

Results: There was a decrease in the severity of LBP (P = 0.033) and in the levels of IL-6 and TNF-[alpha] (P < 0.001) and an increase in sTNF-R1 (P < 0.001) in the first year after an acute episode of LBP. The probability of occurrence of pain relief at the 12-month follow-up was 2.22 times higher in elderly women who had low levels of IL-6 (<1.58 pg/mL) at baseline.

Conclusions: Our findings showed a relationship between inflammation and LBP by establishing that low IL-6 plasma levels preceded outcome (LBP recovery), supporting the concept that proinflammatory cytokines promote pain.

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