(121) Pain, Sleep Disturbances, Fatigue, Mood Changes, and Underlying Inflammation: A Study of Patients with Chronic Low Back Pain (CLBP)

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CLBP is a highly prevalent (55% adults) and expensive (costs range $84-$624.8 billion) condition in the United States. CLBP is accompanied by distressing behavioral symptoms, such as depressed mood, fatigue, and sleep disturbance, which negatively impact quality of life (QOL). The purpose of the study was to determine the extent to which behavioral symptoms (depressive mood, fatigue, poor sleep), independently or as a cluster, predict pain severity and QOL. Proinflammatory cytokine (IL-6) was evaluated to determine the extent to which inflammation may serve as a common underlying mechanism. Further, these symptoms may share a common inflammatory pathway which in turn influence inflammation-related pain. Patients with CLBP (N=69) were enrolled. Participants completed instruments measuring pain severity and interference due to pain, depressive mood, fatigue, sleep quality, and quality of life. A blood sample was collected to measure IL-6. Latent class analysis will be used to identify symptom clusters, and differences among cluster profiles. Preliminary results revealed that 85% of the sample reported experiencing pain that day. Patients reported elevated fatigue, sleep disturbance, and depressive symptoms. Greater pain severity and/or interference was associated with greater sleep disturbance (r=0.59, p=.000; r=.45, p=.000), fatigue (r=.43, p = .001, r=.46, p=.001), depressive symptoms (r=.41, p = .005), and lower QOL (r=-0.39, p=.007). Those who reported greater pain severity indicated that pain interfered with their mood (r=.60, p =.000), social relationships (r=0.51, p=.000), and enjoyment of life (r=.35, p=.010). Greater depressive symptoms (r= -0.61, p=.000), sleep disturbance (r=-.54, p=.000), and fatigue (r=-.32, p=.022) were associated with poorer QOL. Furthermore, greater pain severity was associated with greater levels of plasma IL-6 (r=.42, p=.001). There is an urgent need to improve QOL for those burdened with CLBP, yet clinical management is only moderately effective. A symptom cluster approach in CLBP can guide the development of more comprehensive interventions.