Abstract
Introduction: Systemic inflammation is observed in chronic low back pain (LBP) (Wang et al 2008) and may contribute to the transition from acute to persistent LBP (Klyne et al 2017). Lower back connective tissues are a possible source of this inflammation and can be modified by inflammation. Fibroblasts secrete inflammatory cytokines in response to stretch or injury of the connective tissues (Dodd et al 2006; Wilke et al 2017), which can “spill over” into the bloodstream, leading to widespread secondary tissue damage and activation of pain pathways in the central nervous system (Xin et al 2017). Whether an early increase in systemic cytokines is related to LBP outcome is unclear. This study aimed to determine whether systemic cytokines and C-reactive protein (CRP) during an acute episode of LBP differ between individuals who did and did not recover by 6 months and to identify subgroups based on patterns of inflammatory, psychological, and sleep features associated with recovery/non-recovery.
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