The association of biomarkers with pain and function in acute and subacute low back pain: a secondary analysis of an RCT

BMC Musculoskeletal Disorders

Research Article

Wan Huang¹  Christine McFarland²  Michael Schneider³  Nam Vo⁴  Gwendolyn Sowa⁵  Valerio Tonelli Enrico⁶  Mitchell Haas⁷  Nick Weber⁸ 

[1] Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Kaufmann Medical Building, Suite 910; 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA;Department of Physical Therapy, University of Pittsburgh, 100 Technology Dr, 15219, Pittsburgh, PA, USA;Department of Physical Therapy, University of Pittsburgh, 100 Technology Dr, 15219, Pittsburgh, PA, USA;Clinical and Translational Science Institute, University of Pittsburgh, Forbes Tower, Suite 7057, 15213, Pittsburgh, PA, USA;Ferguson Laboratory for Orthopaedic and Spine Research, Department of Orthopaedic Surgery, University of Pittsburgh, 200 Lothrop Street, Room E1612, BST, 15261, Pittsburgh, PA, USA;Ferguson Laboratory for Orthopaedic and Spine Research, Department of Orthopaedic Surgery, University of Pittsburgh, 200 Lothrop Street, Room E1612, BST, 15261, Pittsburgh, PA, USA;Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Kaufmann Medical Building, Suite 910; 3471 Fifth Avenue, 15213, Pittsburgh, PA, USA;Ferguson Laboratory for Orthopaedic and Spine Research, Department of Orthopaedic Surgery, University of Pittsburgh, 200 Lothrop Street, Room E1612, BST, 15261, Pittsburgh, PA, USA;Department of Physical Therapy, University of Pittsburgh, 100 Technology Dr, 15219, Pittsburgh, PA, USA;Integrative Health & Wellbeing Program, University of Minnesota, MMC 505; 420 Delaware Street S.E, 55455, Minneapolis, MN, USA;Shirley Ryan AbilityLab, Chicago, 355 E Erie St, 60611, Chicago, IL, USA;Department of Physical Medicine & Rehabilitation, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Dr #1022, 60611, Chicago, IL, USA;

关键词: Acute low back pain;    Biomarkers;    Chiropractic;    Medical care;    Inflammation;    Spinal manipulation;   

DOI  :  10.1186/s12891-022-06027-9

 received in 2022-06-15, accepted in 2022-11-24,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundLow back pain (LBP) is a common musculoskeletal condition and a major cause of disability worldwide. Previous studies have found associations of biomarkers with pain and pain-related disability in LBP patients. This study aimed to explore the association between serum biomarkers and pain and disability in patients with acute or subacute axial LBP.MethodsThis study was ancillary to a parent randomized controlled trial. Enrolled participants were randomized into three intervention groups: one of two types of spinal manipulation or medical care. In the parent study, 107 adults who experienced a new episode of LBP within 3 months prior to enrollment were recruited. For this study, 90 of these 107 participants consented to have blood samples obtained, which were drawn immediately before the beginning of treatment. Seven biomarkers were chosen based on previous literature and analyzed. Clinical outcomes were pain and Oswestry Disability Index (ODI) evaluated at baseline and 4 weeks. Spearman’s |r| was used to study the association of initial levels of each biomarker with pain and ODI scores at baseline and with changes in outcome scores from baseline to 4 weeks (end of treatment) within each intervention group.ResultsAt baseline, 4 of 7 biomarkers had an association with pain that was |r| ≥ .20: neuropeptide Y (NPY) (r = 0.23, p = .028), E-Selectin (r = 0.22, p = .043), vitamin D ((r = − 0.32, p = .002), and c-reactive protein (CRP) (r = 0.37, p = .001). No baseline biomarker had an association with disability that was |r| ≥ 0.20. For the correlations of baseline biomarkers with 4-week change in outcomes, vitamin D showed a correlation with change in disability and/or pain (|r| ≥ 0.20, p > .05) in manipulation-related groups, while CRP, NPY, and E-selectin along with TNFα, Substance P and RANTES showed at least one correlation with change in pain or disability (|r| ≥ 0.20, p > .05) in at least one of the treatment groups.ConclusionsIn 90 LBP patients, the analyzed biomarkers, especially vitamin D, represent a small set of potential candidates for further research aimed at individualizing patient care. Overall, the associations investigated in the current study are an initial step in identifying the direct mechanisms of LBP and predicting outcomes of manipulation-related treatments or medical care.Trial registrationClinicalTrials.gov Identifier: NCT01211613, Date of Registration: September 29, 2010, https://clinicaltrials.gov/ct2/show/NCT01211613?term=schneider&cond=Low+Back+Pain&cntry=US&state=US%3APA&draw=2&rank=1

【 授权许可】

CC BY   
© The Author(s) 2022