The interleukin-1α gene C>T polymorphism rs1800587 is associated with increased pain intensity and decreased pressure pain thresholds in patients with lumbar radicular pain

Abstract Aims Previous studies have suggested that many inflammatory cytokines, including interleukin (IL)-1α, may be associated with lumbar radicular pain after disc herniation. In the present study, we examined how variability of the IL-1α gene affects pain intensity and the pressure pain threshold (PPT) in patients with symptomatic disc herniation. Methods A total of 121 patients with lumbar radicular pain due to disc herniation were recruited from Oslo University Hospital, Norway, and followed up at 6 weeks and 12 months. The primary outcome measures were pain intensity scores for the lower back and legs using a visual analog pain scale (VAS) and PPT for the gluteal muscles. Genotyping was carried out using a predesigned TaqMan assay for IL-1α rs1800587. The effect of the IL-1α genotype on the VAS and PPT was analyzed by repeated measure analyses of variance. Results The IL-1α gene C>T polymorphism rs1800587 affected VAS and PPT scores in patients with symptomatic disc herniation. Patients with the CT/TT genotype reported a higher VAS leg pain intensity (p = 0.002) and also a lower PPT in the gluteal muscles (left p = 0.016; right p = 0.016) compared to patients with the CC genotype during 1 year of follow-up. Conclusions The present data show that the IL-1α CT/TT genotype rs1800587 may be associated with increased pain intensity, and corresponding reduced PPT during the first year after disc herniation.

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The Interleukin-1α Gene C>T Polymorphism rs1800587 is Associated With Increased Pain Intensity and Decreased Pressure Pain Thresholds in Patients With Lumbar Radicular Pain

Clinical Journal of Pain ◽

10.1097/ajp.0000000000000048 ◽

2014 ◽

Vol 30 (10) ◽

pp. 869-874 ◽

Cited By ~ 13

Author(s):

Elina I. Schistad ◽

Line M. Jacobsen ◽

Cecilie Røe ◽

Johannes Gjerstad

Keyword(s):

Pain Intensity ◽

Radicular Pain ◽

Pain Thresholds ◽

Pressure Pain ◽

Pressure Pain Thresholds ◽

Interleukin 1Α ◽

Lumbar Radicular Pain

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Inflammatory Serum Protein Profiling of Patients with Lumbar Radicular Pain One Year after Disc Herniation

International Journal of Inflammation ◽

10.1155/2016/3874964 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 19

Author(s):

Aurora Moen ◽

Anne-Li Lind ◽

Måns Thulin ◽

Masood Kamali-Moghaddam ◽

Cecilie Røe ◽

...

Keyword(s):

Disc Herniation ◽

Serum Proteins ◽

Protein Profile ◽

Radicular Pain ◽

Protein Profiling ◽

University Hospital ◽

Serum Profiling ◽

Inflammatory Protein ◽

Lumbar Radicular Pain ◽

One Year

Earlier studies suggest that lumbar radicular pain following disc herniation may be associated with a local or systemic inflammatory process. In the present study, we investigated the serum inflammatory protein profile of such patients. All 45 patients were recruited from Oslo University Hospital, Ullevål, Norway, during the period 2007–2009. The new multiplex proximity extension assay (PEA) technology was used to analyze the levels of 92 proteins. Interestingly, the present data showed that patients with radicular pain 12 months after disc herniation may be different from other patients with regard to many measurable serum cytokines. Given a false discovery rate (FDR) of 0.10 and 0.05, we identified 41 and 13 proteins, respectively, which were significantly upregulated in the patients with severe pain one year after disc herniation. On the top of the list ranked by estimated increase we found C-X-C motif chemokine 5 (CXCM5; 217% increase), epidermal growth factor (EGF; 142% increase), and monocyte chemotactic protein 4 (MCP-4; 70% increase). Moreover, a clear overall difference in the serum cytokine profile between the chronic and the recovered patients was demonstrated. Thus, the present results may be important for future protein serum profiling of lumbar radicular pain patients with regard to prognosis and choice of treatment. We conclude that serum proteins may be measurable molecular markers of persistent pain after disc herniation.

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Faculty Opinions recommendation of Predictors of a favorable response to transforaminal injection of steroids in patients with lumbar radicular pain due to disc herniation.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.13196958.14539059 ◽

2011 ◽

Author(s):

Michael Erdek

Keyword(s):

Disc Herniation ◽

Radicular Pain ◽

Lumbar Radicular Pain

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Percutaneous Fascia Release for Treating Chronic Recurrent Gluteal Myofascial Pain—A Pilot Study of a New Technique

Rehabilitation Process and Outcome ◽

10.4137/rpo.s30483 ◽

2015 ◽

Vol 4 ◽

pp. RPO.S30483 ◽

Cited By ~ 1

Author(s):

Hsin-Shui Chen ◽

Ming-Ta Lin ◽

Chang-Zern Hong ◽

Yueh-Ling Hsieh ◽

Li-Wei Chou

Keyword(s):

Pilot Study ◽

Pain Intensity ◽

Pain Threshold ◽

Myofascial Pain ◽

Pressure Pain Threshold ◽

Small Sample ◽

Myofascial Trigger Points ◽

Pressure Pain ◽

Hip Abduction ◽

Abduction Strength

Objective To investigate the therapeutic effectiveness of percutaneous fascia release to treat chronic recurrent gluteal myofascial pain related to recurrent tendonitis or bursitis at the attachment sites. Methods Five patients (three males, two females; aged 48.6 ± 8.9 years) with myofascial trigger points in the gluteus medius muscle were treated. Outcome measures, including pain intensity, pressure pain threshold, and the relative strength of hip abduction, were assessed before, immediately after, and six months after the treatment. The data measured before and after treatment (different times) on visual analog scale, pressure pain threshold, and relative hip abduction strength were analyzed by Wilcoxon signed-rank test and paired t-test, respectively, for the comparisons between time points. Results Reduction in pain intensity and increase in the pressure pain threshold and the relative hip abduction strength were found in all five patients after treatment when compared with those of before treatment ( P < 0.05). Moreover, all of these improvements existed for at least six months ( P > 0.05). Conclusions Percutaneous fascia release of gluteal muscle insertion sites can be used to treat chronic gluteal pain related to subtrochanteric bursitis to avoid recurrence, if other treatment cannot control the recurrence, although this was demonstrated only on a small sample size without control and blind assessment in the pilot study.

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The Distinction of Hot Herbal Compress, Hot Compress, and Topical Diclofenac as Myofascial Pain Syndrome Treatment

Journal of Evidence-Based Integrative Medicine ◽

10.1177/2156587217753451 ◽

2018 ◽

Vol 23 ◽

pp. 215658721775345 ◽

Cited By ~ 1

Author(s):

Jurairat Boonruab ◽

Netraya Nimpitakpong ◽

Watchara Damjuti

Keyword(s):

Quality Of Life ◽

Pain Intensity ◽

Range Of Motion ◽

Pain Threshold ◽

Pressure Pain Threshold ◽

Pressure Pain ◽

Cervical Range Of Motion ◽

Topical Diclofenac ◽

Hot Compress

This randomized controlled trial aimed to investigate the distinctness after treatment among hot herbal compress, hot compress, and topical diclofenac. The registrants were equally divided into groups and received the different treatments including hot herbal compress, hot compress, and topical diclofenac group, which served as the control group. After treatment courses, Visual Analog Scale and 36-Item Short Form Health survey were, respectively, used to establish the level of pain intensity and quality of life. In addition, cervical range of motion and pressure pain threshold were also examined to identify the motional effects. All treatments showed significantly decreased level of pain intensity and increased cervical range of motion, while the intervention groups exhibited extraordinary capability compared with the topical diclofenac group in pressure pain threshold and quality of life. In summary, hot herbal compress holds promise to be an efficacious treatment parallel to hot compress and topical diclofenac.

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Microsurgical Excision of Herniated Lumber Disc in Pediatric Population

Neuroscience and Neurological Surgery ◽

10.31579/2578-8868/008 ◽

2018 ◽

Vol 2 (3) ◽

pp. 01-05

Author(s):

Ahmed Zaher

Keyword(s):

Back Pain ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Pediatric Population ◽

Lumbar Disc ◽

Radicular Pain ◽

University Hospital ◽

Csf Leak ◽

Degree Relative ◽

History Of

Lumbar disc herniation is a relatively rare disorder among children and adolescent population compared to adults. The objectives of this work are to study the lumbar disc herniation in pediatric population and determine the surgical outcome of lumbar microdiscectomy in such population. Patients and methods: A series of 32 pediatric patients less than 18 years operated by microdiscectomy at Mansoura University hospital during the period from January 2005 to March 2015 were retrospectively analyzed. Clinical presentation, physical signs, predisposing factors, radiological investigations and operative findings were retrieved from medical records. Improvement of pain was assessed by visual analogue scale. Results: The study included 17 females (53.1%) and 15 males (46.9%) ranging in age from 10 to18 years (mean, 14.2 year). The patients were followed up for periods ranging from three to 115 months (mean, 55 months). All patients had radicular pain (100%) with additional back pain in twenty one patients (65.63%), twenty eight patients (87.5%) presented by sciatic pain while six patients (18.75%) showed femoral neuralgia. Straight leg raising test was positive in 90.62%. L4/5 was the commonest affected level in eighteen patients (56.25%) while twelve patients (37.5%) had disc herniation at L5-S1 level and only two patients had herniation at L3-4 disc level. Family history of lumbar disc herniation in first degree relative was positive in twenty one patients (65.63%). History of relevant trauma was documented in only twelve patients (37.5%). During surgery the disc was soft, rubbery and well hydrated in 90.6% of cases. Subligamentous disc herniation was observed in 81%, while 12.5% of patients had disc bulge with intact annulus and only 6.5% had extruded disc. All patients showed significant improvement of radicular pain at the time of discharge while back pain continued to improve during early postoperative follow up. Low back pain and radicular pain equally improved after three months despite instant postoperative improvement of radicular pain. Postoperative complications were rare and included one case of wound infection, one case of iatrogenic CSF leak and new neurological deficit in another case. Conclusion: Lumbar disc herniation in pediatric population differs from that of adults in many aspects. Microdiscectomy is safe and reliable procedure for management of pediatric lumbar disc herniation with good outcome and minimal morbidity

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Myalgia in 30 Patients with Suspected Myopathy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17072502 ◽

2020 ◽

Vol 17 (7) ◽

pp. 2502

Author(s):

Diana Lehmann Urban ◽

Elizabeth Lehmann ◽

Leila Motlagh Scholle ◽

Torsten Kraya

Keyword(s):

Pain Intensity ◽

Polymyalgia Rheumatica ◽

Pain Sensitivity ◽

Pain Threshold ◽

Neuromuscular Disorders ◽

Pressure Pain Threshold ◽

Neuromuscular Disorder ◽

Weak Correlation ◽

Pressure Pain ◽

Significant Difference

Background: In patients with neuromuscular disorder, only little data of myalgia frequency and characterization exists. To date, only a weak correlation between pain intensity and pressure pain threshold has been found, and it remains enigmatic whether high pain intensity levels are equivalent to high pain sensitivity levels in neuromuscular disorders. Methods: 30 sequential patients with suspected neuromuscular disorder and myalgia were analyzed with regard to myalgia characteristics and clinical findings, including symptoms of depression and anxiety and pain- threshold. Results: A neuromuscular disorder was diagnosed in 14/30 patients. Muscular pain fasciculation syndrome (MPFS) without evidence for myopathy or myositis was diagnosed in 10/30 patients and 6/30 patients were diagnosed with pure myalgia without evidence for a neuromuscular disorder (e.g., myopathy, myositis, MPFS, polymyalgia rheumatica). Highest median pain scores were found in patients with pure myalgia and polymyalgia rheumatica. Pressure pain threshold measurement showed a significant difference between patients and controls in the biceps brachii muscle. Conclusion: Only a weak correlation between pain intensity and pressure pain threshold has been suggested, which is concordant with our results. The hypothesis that high pain intensity levels are equivalent to high pain sensitivity levels was not demonstrated.

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Percutaneous Soft Tissue Release for Treating Chronic Recurrent Myofascial Pain Associated with Lateral Epicondylitis: 6 Case Studies

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2012/142941 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Ming-Ta Lin ◽

Li-Wei Chou ◽

Hsin-Shui Chen ◽

Mu-Jung Kao

Keyword(s):

Soft Tissue ◽

Pain Intensity ◽

Pain Threshold ◽

Myofascial Pain ◽

Pressure Pain Threshold ◽

Lateral Epicondylitis ◽

Soft Tissue Release ◽

Recurrent Pain ◽

Myofascial Trigger Points ◽

Pressure Pain

Objective. The purpose of this pilot study is to investigate the effectiveness of the percutaneous soft tissue release for the treatment of recurrent myofascial pain in the forearm due to recurrent lateral epicondylitis.Methods. Six patients with chronic recurrent pain in the forearm with myofascial trigger points (MTrPs) due to chronic lateral epicondylitis were treated with percutaneous soft tissue release of Lin’s technique. Pain intensity (measured with a numerical pain rating scale), pressure pain threshold (measured with a pressure algometer), and grasping strength (measured with a hand dynamometer) were assessed before, immediately after, and 3 months and 12 months after the treatment.Results. For every individual case, the pain intensity was significantly reduced(P<0.01)and the pressure pain threshold and the grasping strength were significantly increased(P<0.01)immediately after the treatment. This significant effectiveness lasts for at least one year.Conclusions. It is suggested that percutaneous soft tissue release can be used for treating chronic recurrent lateral epicondylitis to avoid recurrence, if other treatment, such as oral anti-inflammatory medicine, physical therapy, or local steroid injection, cannot control the recurrent pain.

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Immediate Effects of Region-Specific and Non–Region-Specific Spinal Manipulative Therapy in Patients With Chronic Low Back Pain: A Randomized Controlled Trial

Physical Therapy ◽

10.2522/ptj.20120256 ◽

2013 ◽

Vol 93 (6) ◽

pp. 748-756 ◽

Cited By ~ 36

Author(s):

Ronaldo Fernando de Oliveira ◽

Richard Eloin Liebano ◽

Lucíola da Cunha Menezes Costa ◽

Lívia Leticia Rissato ◽

Leonardo Oliveira Pena Costa

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Spinal Manipulation ◽

Pain Threshold ◽

Controlled Trial ◽

Pressure Pain Threshold ◽

Low Back ◽

Pressure Pain ◽

Upper Thoracic

Background Manual therapists typically advocate the need for a detailed clinical examination to decide which vertebral level should be manipulated in patients with low back pain. However, it is unclear whether spinal manipulation needs to be specific to a vertebral level. Objective The purpose of this study was to analyze the immediate effects of a single, region-specific spinal manipulation defined during the clinical examination versus a single non–region-specific spinal manipulation (applied on an upper thoracic vertebra) in patients with chronic nonspecific low back pain for the outcome measures of pain intensity and pressure pain threshold at the time of the assessment. Design This was a 2-arm, prospectively registered, randomized controlled trial with a blinded assessor. Setting The study was conducted in an outpatient physical therapy clinic in Brazil. Patients The study participants were 148 patients with chronic nonspecific low back pain (with pain duration of at least 12 weeks). Randomization The randomization schedule was generated by an independent statistician and was concealed by using consecutively numbered, sealed, opaque envelopes. Interventions A single high-velocity manipulation was administered to the upper thoracic region of the participants allocated to the non–region-specific manipulation group and to the painful lumbar levels of the participants allocated to the region-specific manipulation group. Measurements Pain intensity was measured by a 0 to 10 numeric pain rating scale. Pressure pain threshold was measured using a pressure algometer. Limitations It was not possible to blind the therapist and participants. Results A total of 148 patients participated in the study (74 in each group). There was no loss to follow-up. Both groups improved in terms of immediate decrease of pain intensity; however, no between-group differences were observed. The between-group difference for pain intensity and pressure pain threshold were 0.50 points (95% confidence interval=−0.10 to 1.10) and −1.78 points (95% confidence interval=−6.40 to 2.82), respectively. No adverse reactions were observed. Conclusion The immediate changes in pain intensity and pressure pain threshold after a single high-velocity manipulation do not differ by region-specific versus non–region-specific manipulation techniques in patients with chronic low back pain.

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