It has been suggested that alterations in
inflammation molecules maintain
chronic pain although little is known about how these factors influence homeostatic and inflammatory events in common
chronic pain conditions. Nonpharmacological interventions might be associated with alterations in
inflammation markers in blood. This study of patients with
chronic pain investigates whether an interdisciplinary multimodal rehabilitation program (IMMRP) was associated with significant alterations in the plasma pattern of 68
cytokines/
chemokines 1 year after rehabilitation and whether such changes were associated with clinical changes. Blood samples and self-reports of
pain, psychological distress, and physical activity of 25 complex
chronic pain patients were collected pre-IMMRP and at 12-month follow-up. Analyses of inflammatory
proteins (
cytokines/
chemokines/
growth factors) were performed directly in plasma using the multiplex immunoassay technology Meso Scale Discovery. This explorative pilot study found that 12 substances, mainly pro-inflammatory, decreased after IMMRP. In two other relatively small IMMRP studies, four of these proinflammatory markers were also associated with decreases. The pattern of
cytokines/
chemokines pre-IMMRP was associated with changes in psychological distress but not with
pain or physical activity. The present study cannot impute cause and effect. These results together with the results of the two previous IMMRP studies suggest that there is a need for larger and more strictly controlled studies of IMMRP with respect to inflammatory markers in blood. Such studies need to consider responders/non-responders, additional
therapies, involved
pain mechanisms and diagnoses. This and the two other studies open up for developing biologically measurable outcomes from plasma. Such
biomarkers will be an important tool for further development of IMMRP and possibly other treatments for patients w ith
chronic pain.