Well-Being, Inflammation, and Physical Activity in Acute and Chronic Back Pain: A Cross-Sectional Analysis of 22,864 UK Biobank Participants

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-07-20 DOI:10.1002/ejp.70079

Romina Gollan, Patrick J. Owen, Jamie L. Tait, Luana C. Main

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Abstract

Background

Back pain is influenced by biological, psychological, and social factors, yet is often investigated separately.

Methods

Cross-sectional analysis of the UK Biobank comparing well-being (Patient Health Questionnaire-4; 4–16 points; higher scores indicate greater levels of depressive and anxiety symptoms), number of stressful life events, C-reactive protein (CRP), and physical activity (International Physical Activity Questionnaire) among pain-free, acute, and chronic back pain individuals. The sample included 22,864 individuals: 5716 with acute back pain, 5716 with chronic back pain, and 11,432 pain-free controls. Group comparisons were performed using network analysis and analysis of covariance, adjusted for socioeconomic deprivation, body mass index, smoking, and alcohol consumption.

Results

Well-being was poorer in acute (mean difference [95% CI]: 0.20 [0.14, 0.25] points; p < 0.001) and chronic back pain (0.39 [0.34, 0.45] points; p < 0.001) compared to controls. More stressful life events were measured in acute (0.03 [0.01, 0.05] points; p = 0.041) and chronic back pain (0.03 [0.01, 0.05] points; p = 0.028) compared to controls. However, this finding was not robust to sensitivity analyses. Elevated CRP was found in acute (2.28 [0.57, 3.99]%; p = 0.024; ES = very small), but not in chronic back pain, compared to controls. No significant group differences were observed for physical activity. Network structures did not differ between groups.

Conclusions

Differences in well-being and CRP among pain-free, acute, and chronic back pain individuals were identified, suggesting that variables may be affected by back pain temporality. Further prospective research incorporating additional variables is needed to explore the drivers of back pain.

Significance Statement

Individuals with acute back pain showed 2% higher CRP than controls, though values remained within the normal range (< 5 mg/L) across groups and below clinical relevance, suggesting limited utility of CRP in distinguishing acute from chronic back pain. Poorer well-being in both acute and chronic back pain underscores the need to explore underlying causal pathways. Moreover, similar network structures among groups indicate no neuroimmune involvement in back pain onset or chronification based on the variables examined.

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急性和慢性背痛的健康、炎症和身体活动：22,864名英国生物银行参与者的横断面分析

背部疼痛受生物、心理和社会因素的影响，但经常被单独调查。方法对英国生物银行进行横断面分析，比较幸福感(患者健康问卷-4；4-16点;在无痛、急性和慢性背痛患者中，得分越高表明抑郁和焦虑症状的水平越高)、压力生活事件的数量、c反应蛋白（CRP）和身体活动（国际身体活动问卷）。样本包括22,864人：5716名急性背痛患者，5716名慢性背痛患者，11,432名无痛对照者。采用网络分析和协方差分析进行组间比较，并根据社会经济剥夺、体重指数、吸烟和饮酒进行调整。结果急性期患者幸福感较差(95% CI: 0.20[0.14, 0.25]点；P < 0.001)和慢性背痛(0.39[0.34,0.45]分；P < 0.001)。急性期压力生活事件较多（0.03[0.01,0.05]分）；P = 0.041)和慢性背痛(0.03[0.01,0.05]分；P = 0.028)。然而，这一发现在敏感性分析中并不可靠。急性期CRP升高(2.28 [0.57,3.99]%；p = 0.024；ES =非常小)，但与对照组相比，慢性背痛没有变化。在体力活动方面没有观察到显著的组间差异。两组之间的网络结构没有差异。结论：在无痛、急性和慢性背痛个体中，幸福感和CRP的差异被确定，这表明变量可能受到背痛暂时性的影响。需要进一步纳入其他变量的前瞻性研究来探索背痛的驱动因素。急性背痛患者的CRP水平比对照组高2%，但各组的CRP水平仍在正常范围内（5mg /L），低于临床相关性，这表明CRP在区分急性和慢性背痛方面的作用有限。急性和慢性背痛患者的健康状况较差，这强调了探索潜在因果途径的必要性。此外，根据所检查的变量，各组之间相似的网络结构表明没有神经免疫参与背痛的发病或慢性化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.