Association between Serum Levels of High Sensitivity C-Reactive Protein, Interleukin-1 and Interleukin-6 with Pain Intensity in Patients with Low Back Pain without Sciatica
BACKGROUND: A strictly mechanical and pathoanatomical explanation for low back pain (LBP) and sciatica has proved inadequate; therefore, the role of biochemical and inflammatory factors remains under investigation.
AIM: The aim of this study is to evaluate whether there is any association between serum levels of high sensitivity C-reactive protein (hs-CRP), interleukin-1 (IL-1), and IL-6 with pain intensity in a patient with LBP without sciatica.
METHODS: Venous blood serum levels of hs-CRP, IL-1, and IL-6 were measured on 50 patients with LBP who had a negative LasÃ¨gue test on physical examination. The pain intensity was measured using a visual analog scale (VAS).
RESULTS: There were 50 patients with LBP without sciatica with mean of age of46.72 Â± 10.79-year-old participated in this study comprised 8 (16%) men and 42 (84%) women. The mean serum levels of hs-CRP, IL-1, and IL-6 were 0.50 Â± 0.61 mg/dL, 55.02 Â± 49.73 ng/L, and IL-6 39.43 Â± 38.56 ng/L, respectively. The mean of VAS score was 49.3Â±9.6 mm. There was no significant correlation (r = 0.05; p = 0.72) between hs-CRP serum levels and VAS scores. There was found a weak negative non-significant correlation (r = âˆ’0.10, p = 0.47) between IL-1 serum levels and VAS score. There was found a weak negative non-significant correlation (r = âˆ’0.17, p = 0.23) between IL-6 serum levels and VAS score as well.
CONCLUSION: There was no significant correlation between serum levels of hs-CRP, IL-1, and IL-6 with VAS scores in patient with LBP without sciatica.
Plum Analytics Artifact Widget Block
Choi YS, Kim DJ, Lee KY, Park YS, Cho KJ, Lee JH, et al. How does chronic back pain influence quality of life in Koreans: A cross-sectional study. Asian Spine J. 2014;8(3):346- 52. https://doi.org/10.4184/asj.2014.8.3.346 PMid:24967049
Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The global burden of low back pain: Estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(6):968- 74. https://doi.org/10.1136/annrheumdis-2013-204428 PMid:24665116
Holth HS, Werpen HK, Zwart JA, Hagen K. Physical inactivity is associated with chronic musculoskeletal complaints 11 years later: Results from the Nord-TrÃ¸ndelag health study. BMC Musculoskelet Disord. 2008;9:159. https://doi.org/10.1186/1471-2474-9-159 PMid:19046448
Rathod TN, Chandanwale A, Ladkat KM, Chavan S, Chavan A, Bhosale PB. High sensitive C-reactive protein-effective tool in determining postoperative recovery in lumbar disc disease. Indian J Orthop. 2014;48(4):354-9. https://doi. org/10.4103/0019-5413.136216 PMid:25143637
Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med. 2000;342(12):836- 43. https://doi.org/10.1056/nejm200003233421202 PMid:10733371
StÃ¼rmer T, Raum E, Buchner M, Gebhardt K, Schiltenwolf M, Richter W, et al. Pain and high sensitivity C reactive protein in patients with chronic low back pain and acute sciatic pain. Ann Rheum Dis. 2005;64(6):921-5. https://doi.org/10.1136/ ard.2004.027045 PMid:15897311
Macphail K. C-reactive protein, chronic low back pain and, diet and lifestyle. J Pain Relief. 2014;3:160. https://doi. org/10.4172/2167-0846.1000160
Sugimori K, Kawaguchi Y, Morita M, Kitajima I, Kimura T. High-sensitivity analysis of serum C-reactive protein in young patients with lumbar disc herniation. J Bone Joint Surg Br. 2003;85:1151- 4. https://doi.org/10.1302/0301-620x.85b8.14538
Park CH, Lee SH. Investigation of high-sensitivity C-reactive protein and erythrocyte sedimentation rate in low back pain patients. Korean J Pain. 2010;23(2):147-50. https://doi. org/10.3344/kjp.2010.23.2.147 PMid:20556218
Gebhardt K, Brenner H, StÃ¼rmer T, Raum E, Richter W, Schiltenwolf M, et al. The course of high-sensitive C-reactive protein in correlation with pain and clinical function in patients with acute lumbosciatic pain and chronic low back pain - a 6 months prospective longitudinal study. Eur J Pain. 2006;10(8):711-9. https://doi.org/10.1016/j.ejpain.2005.11.005 PMid:16403662
Refshauge KM, Maher CG. Low back pain investigations and prognosis: A review. Br J Sports Med. 2006;40(6):494-8. PMid:16720885
Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340(6):448-54. https://doi.org/10.1056/nejm199902113400607
Chawla J. Low Back Pain and Sciatica. Medscape; 2018. p. 22.
Younes M, BÃ©jia I, Aguir Z, Letaief M, Hassen-Zrour S, Touzi M, et al. Prevalence and risk factors of disk-related sciatica in an urban population in Tunisia. Joint Bone Spine. 2006;73(5):538- 42. https://doi.org/10.1016/j.jbspin.2005.10.022 PMid:16725362
Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ. 2007;334(7607):1313-7. https://doi. org/10.1136/bmj.39223.428495.be PMid:17585160
DevillÃ© WL, van der Windt DA, DzaferagiÄ‡ A, Bezemer PD, Bouter LM. The test of LasÃ¨gue: Systematic review of the accuracy in diagnosing herniated discs. Spine (Phila Pa 1976). 2000;25(9):1140-7. https://doi. org/10.1097/00007632-200005010-00016 PMid:10788860
Afari N, Mostoufi S, Noonan C, Poeschla B, Succop A, Chopko L, et al. C-reactive protein and pain sensitivity: Findings from female twins. Ann Behav Med. 2011;42(2):277-83. https:// doi.org/10.1007/s12160-011-9297-6 PMid:21785898
Kraychete DC, Sakata RK, Issy AM, Bacellar O, Santos- Jesus R, Carvalho EM. Serum cytokine levels in patients with chronic low back pain due to herniated disc: Analytical cross-sectional study. Sao Paulo Med J. 2010;128(5):259-62. https:// doi.org/10.1590/s1516-31802010000500003 PMid:21181064
Wang K, Bao JP, Yang S, Hong X, Liu L, Xie XH, et al. A cohort study comparing the serum levels of pro- or anti-inflammatory cytokines in patients with lumbar radicular pain and healthy subjects. Eur Spine J. 2016;25(1):1428-34. https://doi. org/10.1007/s00586-015-4349-4 PMid:26684469
Khan AN, Jacobsen HE, Khan J, Filippi CG, Levine M, Lehman RA Jr, et al. Inflammatory biomarkers of low back pain and disc degeneration: A review. Ann N Y Acad Sci. 2017;1410(1):68-84. https://doi.org/10.1111/nyas.13551 PMid:2926541610
Copyright (c) 2020 Khairul Putra Surbakti, Iskandar Nasution (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All rights reserved.