Low back pain in athletes can be controlled with acupuncture by a catecholaminergic pathway: clinical trial

Background: Activation of the sympathetic nervous system attenuates inflammation via catecholamines. Recent evidence has shown that electroacupuncture (EA) activates neuronal networks involved in the release of dopamine and norepinephrine that control systemic inflammation. In muscle, catecholamines are related to cyclic adenosine monophosphate (cAMP). This signaling molecule has been implicated in recovery from sustained contractile activity, which may induce muscular pain, such as that which occurs during low back pain (LBP). Objective: Our aim was to evaluate the effects of EA used for the control of LBP on the activation of the sympathetic nervous system in a randomized controlled clinical trial in athletes. Methods: Two groups of athletes with acute or chronic low back pain were studied. EA, sham EA and pharmacological treatment (diclofenac sodium) were evaluated. The outcome measures included a pain score represented by a visual analogue scale (VAS) and serum levels of catecholamines quantified by enzyme-linked immunosorbent assay. In addition, blood was collected into chilled heparin tubes, placed in 96-well cell culture plates and incubated with an equal volume of Roswell Park Memorial Institute (RPMI) medium, with lipopolysaccharide (LPS) alone or with catecholamines. Tumor necrosis factor (TNF)-α levels in the supernatants were analyzed. Results: The results indicated that the initial pain ratings did not differ between the groups analyzed. EA induced epinephrine secretion but not norepinephrine or dopamine secretion. Although EA and pharmacological treatment did not differ in terms of pain relief, in vitro epinephrine and norepinephrine reduced TNF-α production in response to LPS stimuli. Conclusion: EA activates the sympathetic nervous system and induces the release of epinephrine, which could ameliorate inflammation and protect muscular tissue in addition to relieving pain.

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POS1290 CYTOKINE BIOMARKERS IN COMMON LOW BACK PAIN

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4205 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 926.3-926

Author(s):

R. Dhahri ◽

A. Dghaies ◽

M. Slouma ◽

L. Metoui ◽

I. Gharsallah ◽

...

Keyword(s):

Neuropathic Pain ◽

Low Back Pain ◽

Back Pain ◽

Inflammatory Cytokines ◽

Enzyme Linked Immunosorbent Assay ◽

Healthy Controls ◽

Low Back ◽

Tnf Α ◽

Functional Scores ◽

The Mean

Background:Common low back pain (LBP) is a common health problem affecting 50 to 80% of working age adults. It is one of the common and costly health problems in Tunisia. Actually, the role of the immune response and inflammatory cytokines in the pathogenesis of chronic pain has been of growing interest.Objectives:The aim of this study was to assess whether pro and anti-inflammatory cytokines could be detected in serum in patients with LBP compared with healthy subjects and whether they could be related to pain severity and to clinical findings.Methods:It was a an analytical cross-sectional study including 50 patients with at least three months of LBP, in the department of rheumatology, orthopedics and immunology at the Military Hospital of Tunis between January 1st and March 31, 2020. All patients had a standardized clinical assessment.Levels of serum cytokines IL-6, IL-8, IL-1β and TNF- α, were measured using the chimiluminescence technique. Serum concentration of IL-10 was assayed by the enzyme-linked immunosorbent assay technique (ELISA). The normal levels of cytokines were determined in 50 healthy controls.Results:The mean age of the patients was 41.9 ± 8.4 years and the sex ratio was 4.5. LBP duration was 66.4 months. The mean lumbar visual analog scale (VAS) was 4.5 ± 1.9, and the root VAS was 2.6 ± 2.5. Neuropathic pain was found in 26% of patients. The average BMI was 27 ± 3.7 kg/m2. Only serum level of IL-8 was significantly higher in subjects with LBP compared to healthy controls (p <10-3). IL-1β was indetectable in both patients and controls. Positive correlations were found between IL-8 levels and anxiety/functional scores (r = 0.3; p = 0.02/ r = 0.3; p = 0.04). IL-6 was positively correlated with BMI, and negatively correlated with the Schober test. No correlations were found between serum levels of IL-6, IL-8, IL-10, TNF-α and pain intensity (VAS), neuropathic pain (DN4), fibromyalgia (FIRST), depression (HAD) and various radiological data.Conclusion:Interleukin-8 is a biomarker of common low back pain and correlate with anxiety and functional disability. These results suggest that IL-8 may be a therapeutic target to reduce chronic back pain and reduce the social and profession impact.Disclosure of Interests:None declared

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RESTORATIVE NEUROSTIMULATION FOR MECHANICAL CHRONIC LOW BACK PAIN: LONG TERM RESULTS FROM THE REACTIV8-A CLINICAL TRIAL V. Mehta on behalf of the ReActiv8-A investigators.

10.26226/morressier.5ab3c881a874c600265593ea ◽

2018 ◽

Author(s):

Vivek Mehta

Keyword(s):

Clinical Trial ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Long Term Results ◽

Low Back

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Faculty Opinions recommendation of Acupuncture in patients with acute low back pain: a multicentre randomised controlled clinical trial.

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

10.3410/f.717949908.793462007 ◽

2012 ◽

Author(s):

Rajesh Gupta

Keyword(s):

Clinical Trial ◽

Low Back Pain ◽

Back Pain ◽

Controlled Clinical Trial ◽

Low Back ◽

Acute Low Back Pain ◽

Randomised Controlled Clinical Trial ◽

Randomised Controlled

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Prevention of Low Back Pain in the Military: A Randomized Clinical Trial

10.21236/ada487610 ◽

2008 ◽

Author(s):

Steven Z. George ◽

John D. Childs ◽

Deydre S. Teyhen ◽

Samuel S. Wu ◽

Michael E. Robinson

Keyword(s):

Clinical Trial ◽

Low Back Pain ◽

Back Pain ◽

Randomized Clinical Trial ◽

Low Back ◽

The Military

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Prevention Of Low Back Pain In The Military: A Randomized Clinical Trial

10.21236/ada540513 ◽

2010 ◽

Author(s):

Steven Z. George ◽

John D. Childs ◽

Deydre S. Teyhen ◽

Sanuel S. Wu ◽

Alison Wright ◽

...

Keyword(s):

Clinical Trial ◽

Low Back Pain ◽

Back Pain ◽

Randomized Clinical Trial ◽

Low Back ◽

The Military

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THU0566 THE EFFECT OF KINESIO-TAPING ON CHRONIC NONSPECIFIC LOW BACK PAIN: PRELIMINARY RESULTS OF A DOUBLE BLINDED RANDOMIZED CLINICAL TRIAL.

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2979 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 524.1-525

Author(s):

I. Aachari ◽

K. Samia ◽

T. Latifa ◽

T. Fatima Zahrae ◽

S. Afilal ◽

...

Keyword(s):

Clinical Trial ◽

Low Back Pain ◽

Placebo Group ◽

Back Pain ◽

Randomized Clinical Trial ◽

Clinical Characteristics ◽

Functional Disability ◽

Low Back ◽

Kinesio Taping ◽

Secondary Outcomes

Background:The technique of Kinesio-Taping is a method of adhesive bandage exerting traction on the skin which would favorably influence the muscular and articular systems by reducing the pressure exerted on the subcutaneous mechanoreceptors thus reducing pain and muscle tension.Objectives:The aim of this study is to assess the effectiveness of Kinesio-Taping in the short and medium term on pain and function in patients with chronic nonspecific low back pain compared to a placebo.Methods:We conducted a double-blind, two-arm randomized clinical trial. The study should include a total of 70 patients randomized into 2 groups: Kinesio-Taping (n = 35) and control group (n = 35). To this date we have included 46 patients.All patients receives four I-shaped adhesive strips arranged in a star-like shape and applied to the most painful region of the lower back with a tension between 25% to 30% in the taping group. The placebo group received a taping procedure with no tension.Taping is applied three times (at baseline, fourth and eighth day). Patients are assessed at baseline, on day 14 and at 4 weeks by the Arabic version of the Oswestry Physical and Functional Disability Index (ODI) which is the primary outcome. The secondary outcomes are the assessment of pain and functional disability according to the visual analog scale (VAS) evaluated on a scale of 0 to 10, as well as Rolland-Morris score.Results:Both groups were comparable at baseline concerning the demographical and clinical characteristics (P > 0.05) (table 1). The result of repeated measures ANOVA showed a significant change in ODI score and in VAS for pain and functional disability as well as Rolland-Morris score in both groups. Using the ANCOVA, controlling for pre-test scores, a significant difference was found between the two groups (table 2).Table 1. Clinical characteristics of study population.Conclusion:Our clinical trial offers preliminary evidence on the superiority of Kinesio-Taping in the treatment chronic back pain compared to placebo concerning the reduction of pain and disability. Thus, it can be used as a complementary method in chronic non-specific low back pain.Table 2. Primary and secondary outcomes in the Kinesio-Taping and placebo group.Disclosure of Interests:None declared

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