Endocrine and immunologic parameters indicative of 6-month prognosis after the onset of low back pain or neck/shoulder pain.

Abstract

STUDY DESIGN:

Prospective study.

OBJECTIVES:

To evaluate the prognosis of spine disease by investigating biologic parameters reflecting different physiologic or psychophysiological systems in men and women with acute onset of low back or neck/shoulder complaints.

SUMMARY OF BACKGROUND DATA:

Psychosocial factors may be of importance to the etiology and prognosis of musculoskeletal disorders. The possible mechanisms, however, remain unclear. Stress-induced long-lasting energy mobilization resulting in inhibited anabolism has been discussed. Using a theoretical framework within stress physiology, such psychophysiological processes were recorded by measures of substances representing the anabolic, catabolic, immunologic, and opioid systems.

METHODS:

The study comprised 67 working men and women 21 to 59 years of age seeking care by any caregiver for acute low back and/or neck/shoulder pain. Blood samples were taken and analyzed for 3 methyl 5hydroxy phenylethylene glycol (MHPG, reflecting sympathoadrenomedullary activity), DHEA-s (anabolism), immunoglobulin E, interleukin 6 (immune activity), and beta-endorphin (pain regulation). The participants were followed up for 6 months after the blood samples had been drawn.

RESULTS:

In women, low MHPG, low DHEA-s, and low beta-endorphin predicted persistent disability due to low back complaints. Few significant findings were made for self-reported pain, for neck/shoulder complaints, and for men.

CONCLUSION:

Disturbances of the regulation of certain biologic parameters might be indicators of a prolonged course of low back disease in women. Prospective studies are necessary to enable causal conclusions.

• Authors: H M Hasselhorn, T Theorell, E Vingård, Musculoskeletal Intervention Center (MUSIC)-Norrtälje Study Group
• Journal: Spine (Spine (Phila Pa 1976)) Vol. 26 Issue 3 Pg. E24-9 (Feb 01 2001) ISSN: 0362-2436 [Print] United States
• PMID: 11224875 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Interleukin-6
• Immunoglobulin E
• Methoxyhydroxyphenylglycol
• Dehydroepiandrosterone Sulfate
• beta-Endorphin

Topics

• Adult
• Dehydroepiandrosterone Sulfate (blood)
• Endocrine System (metabolism, physiopathology)
• Female
• Humans
• Immunoglobulin E (blood)
• Interleukin-6 (blood)
• Low Back Pain (blood, immunology, physiopathology)
• Male
• Methoxyhydroxyphenylglycol (blood)
• Middle Aged
• Musculoskeletal Diseases (immunology, metabolism, physiopathology)
• Neck Pain (blood, immunology, physiopathology)
• Pain Measurement
• Predictive Value of Tests
• Prognosis
• Shoulder Pain (blood, immunology, physiopathology)
• Time Factors
• beta-Endorphin (blood)