Psychological and immunological associations with movement-evoked low back pain among older adults

Abstract. Introduction:. Low back pain (LBP) is a leading global factor in disability among older adults. Movement-evoked pain (MEP) is potentially an important mediator in the disability pathway but is predominantly tested in the laboratory. Objectives:. We aimed to explore MEP in the natural envir...

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Main Authors: Riley Kahan, Arthur Woznowski-Vu, Janet L. Huebner, Carl F. Pieper, Adam P. Goode, Steven Z. George, Timothy H. Wideman, Virginia Byers Kraus, Cathleen Colón-Emeric, Corey B. Simon
Format: Article
Language:English
Published: Wolters Kluwer 2025-06-01
Series:PAIN Reports
Online Access:http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001262
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author Riley Kahan
Arthur Woznowski-Vu
Janet L. Huebner
Carl F. Pieper
Adam P. Goode
Steven Z. George
Timothy H. Wideman
Virginia Byers Kraus
Cathleen Colón-Emeric
Corey B. Simon
author_facet Riley Kahan
Arthur Woznowski-Vu
Janet L. Huebner
Carl F. Pieper
Adam P. Goode
Steven Z. George
Timothy H. Wideman
Virginia Byers Kraus
Cathleen Colón-Emeric
Corey B. Simon
author_sort Riley Kahan
collection DOAJ
description Abstract. Introduction:. Low back pain (LBP) is a leading global factor in disability among older adults. Movement-evoked pain (MEP) is potentially an important mediator in the disability pathway but is predominantly tested in the laboratory. Objectives:. We aimed to explore MEP in the natural environment (“daily” MEP) and its correlation with laboratory MEP, along with potential psychological and immunological influences. Method:. Thirty-five older adults with persistent LBP attended a single laboratory session. Pain catastrophizing, pain-related fear of movement, and pain self-efficacy were measured by questionnaire. Resting inflammation and inflammatory reactivity to painful movement were evaluated using serum interleukin-6, tissue necrosis factor alpha, and C-reactive protein (CRP). Laboratory MEP was defined by aggregate pain intensity with a movement provocation test. Daily MEP was measured for the next 7 days using ecological momentary assessment. Results:. Laboratory MEP was strongly correlated with daily MEP (ρ = 0.780, P = <0.001). C-reactive protein (Hedges [g] = 0.266) and interleukin-6 (g = 0.433) demonstrated small to moderate reactivity to painful movement. After controlling for age and multimorbidity, pain catastrophizing and pain self-efficacy explained 24% to 37% variance in laboratory and daily MEP. Resting inflammatory markers were not associated with MEP; however, C-reactive protein reactivity to painful movement explained 19% to 25% variance in laboratory and daily MEP. Conclusion:. Preliminary indication is that laboratory and daily MEP may be proxy measures for one another, and that MEP is influenced by psychological and immunological factors. Future studies will aim to (1) validate findings among older adults with persistent LBP and (2) for clinical phenotyping, clarify complex relationships among psychological and immunological factors with disability pathway components like MEP.
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spelling doaj-art-35a1e3fcfa9947a4a0948de6c3691c1b2025-08-20T02:30:06ZengWolters KluwerPAIN Reports2471-25312025-06-01103e126210.1097/PR9.0000000000001262PR90000000000001262Psychological and immunological associations with movement-evoked low back pain among older adultsRiley Kahan0Arthur Woznowski-Vu1Janet L. Huebner2Carl F. Pieper3Adam P. Goode4Steven Z. George5Timothy H. Wideman6Virginia Byers Kraus7Cathleen Colón-Emeric8Corey B. Simon9a Department of Surgery, Duke University School of Medicine, Durham, NC, USAb School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canadac Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USAd Center for Aging and Human Development, Duke University School of Medicine, Durham, NC, USAf Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USAf Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USAb School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canadac Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USAd Center for Aging and Human Development, Duke University School of Medicine, Durham, NC, USAd Center for Aging and Human Development, Duke University School of Medicine, Durham, NC, USAAbstract. Introduction:. Low back pain (LBP) is a leading global factor in disability among older adults. Movement-evoked pain (MEP) is potentially an important mediator in the disability pathway but is predominantly tested in the laboratory. Objectives:. We aimed to explore MEP in the natural environment (“daily” MEP) and its correlation with laboratory MEP, along with potential psychological and immunological influences. Method:. Thirty-five older adults with persistent LBP attended a single laboratory session. Pain catastrophizing, pain-related fear of movement, and pain self-efficacy were measured by questionnaire. Resting inflammation and inflammatory reactivity to painful movement were evaluated using serum interleukin-6, tissue necrosis factor alpha, and C-reactive protein (CRP). Laboratory MEP was defined by aggregate pain intensity with a movement provocation test. Daily MEP was measured for the next 7 days using ecological momentary assessment. Results:. Laboratory MEP was strongly correlated with daily MEP (ρ = 0.780, P = <0.001). C-reactive protein (Hedges [g] = 0.266) and interleukin-6 (g = 0.433) demonstrated small to moderate reactivity to painful movement. After controlling for age and multimorbidity, pain catastrophizing and pain self-efficacy explained 24% to 37% variance in laboratory and daily MEP. Resting inflammatory markers were not associated with MEP; however, C-reactive protein reactivity to painful movement explained 19% to 25% variance in laboratory and daily MEP. Conclusion:. Preliminary indication is that laboratory and daily MEP may be proxy measures for one another, and that MEP is influenced by psychological and immunological factors. Future studies will aim to (1) validate findings among older adults with persistent LBP and (2) for clinical phenotyping, clarify complex relationships among psychological and immunological factors with disability pathway components like MEP.http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001262
spellingShingle Riley Kahan
Arthur Woznowski-Vu
Janet L. Huebner
Carl F. Pieper
Adam P. Goode
Steven Z. George
Timothy H. Wideman
Virginia Byers Kraus
Cathleen Colón-Emeric
Corey B. Simon
Psychological and immunological associations with movement-evoked low back pain among older adults
PAIN Reports
title Psychological and immunological associations with movement-evoked low back pain among older adults
title_full Psychological and immunological associations with movement-evoked low back pain among older adults
title_fullStr Psychological and immunological associations with movement-evoked low back pain among older adults
title_full_unstemmed Psychological and immunological associations with movement-evoked low back pain among older adults
title_short Psychological and immunological associations with movement-evoked low back pain among older adults
title_sort psychological and immunological associations with movement evoked low back pain among older adults
url http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001262
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