ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2018
ISSLS PRIZE IN CLINICAL SCIENCE 2018: longitudinal analysis of inflammatory, psychological, and sleep-related factors following an acute low back pain episode-the good, the bad, and the ugly.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
52 citing papers in PubMed, 5 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- The clinical course of acute, subacute and persistent low back pain: a systematic review and meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Pooled it
- The importance of inflammatory biomarkers in non-specific acute and chronic low back pain: a systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Pooled it
- Immune-inflammatory and hypothalamic-pituitary-adrenal axis biomarkers are altered in patients with non-specific low back pain: A systematic review.Frontiers in immunology · 2022Pooled it
- A systematic review of the role of inflammatory biomarkers in acute, subacute and chronic non-specific low back pain.BMC musculoskeletal disorders · 2020Pooled it
- Individual recovery expectations and prognosis of outcomes in non-specific low back pain: prognostic factor review.The Cochrane database of systematic reviews · 2019Pooled it
- The association of biomarkers with pain and function in acute and subacute low back pain: a secondary analysis of an RCT.BMC musculoskeletal disorders · 2022Trial
- IL-1α and CRP as key inflammatory mediators linking neuropathic pain, anxiety, and depression in major depressive disorder.BMC psychiatry · 2026Article
- Article
- The effect of tumor necrosis factor-alpha on rheumatoid arthritis-related pain: overview of evidence and mechanistic pathways.Croatian medical journal · 2026Review
- Neuro-immune contributors to persistent musculoskeletal pain: from mechanisms to clinical assessment and management.Musculoskeletal science & practice · 2026Review
- Article
- Subgrouping People With Acute Low Back Pain Based on Psychological, Sensory, and Motor Characteristics: A Cross-Sectional Study.European journal of pain (London, England) · 2025Article
- Transition from acute to chronic low back pain in a community-based cohort.The journal of pain · 2025Article
- Salivary Biomarkers of Inflammation in Patients With Chronic Non-Specific Low Back Pain.Biomarker insights · 2025Article
- Should cognitive behavioral therapy for insomnia be considered for preventing and managing chronic pain?Sleep · 2024Article
- Systemic Inflammation, Sleep, and Psychological Factors Determine Recovery Trajectories for People With Neck Pain: An Exploratory Study.The journal of pain · 2024Article
- Article
- Poor lumbar spine coordination in acute low back pain predicts persistent long-term pain and disability.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- Characterization of pain-related behaviors in a rat model of acute-to-chronic low back pain: single vs. multi-level disc injury.Frontiers in pain research (Lausanne, Switzerland) · 2024Article
- Potential use of salivary TNF-α as a vaccine-induced pain biomarker in people with cerebral palsy and communication disorders.PloS one · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
STUDY
designProspective longitudinal study.
objectiveTo determine whether systemic cytokines and C-reactive protein (CRP) during an acute episode of low back pain (LBP) differ between individuals who did and did not recover by 6 months and to identify sub-groups based on patterns of inflammatory, psychological, and sleep features associated with recovery/non-recovery. Systemic inflammation is observed in chronic LBP and may contribute to the transition from acute to persistent LBP. Longitudinal studies are required to determine whether changes present early or develop over time. Psychological and/or sleep-related factors may be related.
methodsIndividuals within 2 weeks of onset of acute LBP (N = 109) and pain-free controls (N = 55) provided blood for assessment of CRP, tumor necrosis factor (TNF), interleukin-6 (IL-6) and interleukin-1β, and completed questionnaires related to pain, disability, sleep, and psychological status. LBP participants repeated measurements at 6 months. Biomarkers were compared between LBP and control participants at baseline, and in longitudinal (baseline/6 months) analysis, between unrecovered (≥pain and disability), partially recovered (reduced pain and/or disability) and recovered (no pain and disability) participants at 6 months. We assessed baseline patterns of inflammatory, psychological, sleep, and pain data using hierarchical clustering and related the clusters to recovery (% change in pain) at 6 months.
resultsCRP was higher in acute LBP than controls at baseline. In LBP, baseline CRP was higher in the recovered than non-recovered groups. Conversely, TNF was higher at both time-points in the non-recovered than recovered groups. Two sub-groups were identified that associated with more ("inflammatory/poor sleep") or less ("high TNF/depression") recovery.
conclusionsThis is the first evidence of a relationship between an "acute-phase" systemic inflammatory response and recovery at 6 months. High inflammation (CRP/IL-6) was associated with good recovery, but specific elevation of TNF, along with depressive symptoms, was associated with bad recovery. Depression and TNF may have a two-way relationship. These slides can be retrieved under Electronic Supplementary Material.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.