Multiple confounders influence the association between low-grade systemic inflammation and musculoskeletal pain. A call for a prudent interpretation of the literature

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Author(s)
Schipholt, IJ Lutke
Scholten-Peeters, GGM
Bontkes, HJ
Coppieters, MW
Griffith University Author(s)
Year published
2018
Metadata
Show full item recordAbstract
Our understanding of the multiple systems and their interactions that contribute to musculoskeletal pain has evolved considerably in recent years. There is a considerable interest in the role of the immune system in both acute and persistent musculoskeletal pain states [1], [2]. Systemically elevated levels of proinflammatory cytokines and chemokines have been revealed in people with musculoskeletal pain. This low-grade inflammation has been demonstrated in various musculoskeletal conditions, such as low back pain [1], neck pain [2], and radicular pain [3]. In addition, levels of inflammatory biomarkers are associated with ...
View more >Our understanding of the multiple systems and their interactions that contribute to musculoskeletal pain has evolved considerably in recent years. There is a considerable interest in the role of the immune system in both acute and persistent musculoskeletal pain states [1], [2]. Systemically elevated levels of proinflammatory cytokines and chemokines have been revealed in people with musculoskeletal pain. This low-grade inflammation has been demonstrated in various musculoskeletal conditions, such as low back pain [1], neck pain [2], and radicular pain [3]. In addition, levels of inflammatory biomarkers are associated with pain severity in people with neck and shoulder pain [4] and low back pain [1]. Moreover, an initial study suggests that inflammatory responses in the acute phase of low back pain may also be related to recovery [5]. In people with and without musculoskeletal pain, levels of inflammatory biomarkers are influenced by multiple factors, such as demographic variables (eg, age and gender), lifestyle factors (eg, physical activity, saturated fat intake, and sleep quality), psychological factors (eg, depression and catastrophizing), and various diseases (eg, cardiovascular and osteoarthritis) [6–8]. These factors can increase systemic cytokine concentrations via their direct or indirect action on immune cells and the subsequent release of inflammatory cytokines and chemokines [7]. Therefore, adjustment for potential confounders is essential to determine the level of association between low-grade systemic inflammation, musculoskeletal pain, and recovery.
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View more >Our understanding of the multiple systems and their interactions that contribute to musculoskeletal pain has evolved considerably in recent years. There is a considerable interest in the role of the immune system in both acute and persistent musculoskeletal pain states [1], [2]. Systemically elevated levels of proinflammatory cytokines and chemokines have been revealed in people with musculoskeletal pain. This low-grade inflammation has been demonstrated in various musculoskeletal conditions, such as low back pain [1], neck pain [2], and radicular pain [3]. In addition, levels of inflammatory biomarkers are associated with pain severity in people with neck and shoulder pain [4] and low back pain [1]. Moreover, an initial study suggests that inflammatory responses in the acute phase of low back pain may also be related to recovery [5]. In people with and without musculoskeletal pain, levels of inflammatory biomarkers are influenced by multiple factors, such as demographic variables (eg, age and gender), lifestyle factors (eg, physical activity, saturated fat intake, and sleep quality), psychological factors (eg, depression and catastrophizing), and various diseases (eg, cardiovascular and osteoarthritis) [6–8]. These factors can increase systemic cytokine concentrations via their direct or indirect action on immune cells and the subsequent release of inflammatory cytokines and chemokines [7]. Therefore, adjustment for potential confounders is essential to determine the level of association between low-grade systemic inflammation, musculoskeletal pain, and recovery.
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Journal Title
The Spine Journal
Volume
18
Issue
11
Copyright Statement
© 2018 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
Subject
Clinical Sciences
Neurosciences
Science & Technology
Life Sciences & Biomedicine
Clinical Neurology
Orthopedics
Neurosciences & Neurology