C-reactive protein (CRP) is associated with chronic pain independently of biopsychosocial factors
Inflammation is linked with chronic pain but the extent to which this relationship is associated with biopsychosocial factors is not known. We investigated relationships between blood C-reactive protein (CRP) and regional chronic pain conditions adjusting for a large range and number of potential co...
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| Veröffentlicht in: | The journal of pain 2024-02, Vol.25 (2), p.476-496 |
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| container_title | The journal of pain |
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| creator | Farrell, Scott F. Armfield, Nigel R. Cabot, Peter J. Elphinston, Rachel A. Gray, Paul Minhas, Gunjeet Collyer, Martin R. Sterling, Michele |
| description | Inflammation is linked with chronic pain but the extent to which this relationship is associated with biopsychosocial factors is not known. We investigated relationships between blood C-reactive protein (CRP) and regional chronic pain conditions adjusting for a large range and number of potential confounders. We performed cross-sectional analyses using the UK Biobank (N=415,567) comparing CRP in people reporting any of nine types of regional chronic pain with pain-free controls. Using logistic regression modelling, we explored relationships between CRP and the presence of chronic pain, with demographic, socioeconomic, psychological/lifestyle factors, and medical comorbidities as covariates. CRP was higher in chronic pain at any site compared with controls (Females: median [IQR] 1.60mg/L [2.74] vs 1.17mg/L [1.87], P |
| doi_str_mv | 10.1016/j.jpain.2023.09.008 |
| format | Article |
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Using a large-scale dataset, this article investigates associations between chronic pain conditions and blood C-reactive protein (CRP), to evaluate the confounding effects of a range of biopsychosocial factors. CRP levels were higher in those with chronic pain vs controls after adjusting for confounders—suggesting a possible independent biological mechanism.
•In the UK Biobank, chronic pain is associated with higher blood CRP levels•This association was attenuated but still significant after confounder adjustment•This may reflect a pathophysiologic role of systemic inflammation in chronic pain</description><identifier>ISSN: 1526-5900</identifier><identifier>EISSN: 1528-8447</identifier><identifier>DOI: 10.1016/j.jpain.2023.09.008</identifier><identifier>PMID: 37741522</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>back pain ; Biomarkers ; C-reactive protein ; C-Reactive Protein - analysis ; C-Reactive Protein - metabolism ; Chronic pain ; Chronic Pain - complications ; Cross-Sectional Studies ; Female ; Humans ; inflammation ; Inflammation - complications ; Male ; neck pain</subject><ispartof>The journal of pain, 2024-02, Vol.25 (2), p.476-496</ispartof><rights>2023</rights><rights>Copyright © 2024 United States Association for the Study of Pain, Inc. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-3efa36507716eb9edf197f2c34ed833bc8a0caf2fbf6015f09e7f0e52303ab193</citedby><cites>FETCH-LOGICAL-c359t-3efa36507716eb9edf197f2c34ed833bc8a0caf2fbf6015f09e7f0e52303ab193</cites><orcidid>0000-0003-1772-2248 ; 0000-0002-1369-1483</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37741522$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Farrell, Scott F.</creatorcontrib><creatorcontrib>Armfield, Nigel R.</creatorcontrib><creatorcontrib>Cabot, Peter J.</creatorcontrib><creatorcontrib>Elphinston, Rachel A.</creatorcontrib><creatorcontrib>Gray, Paul</creatorcontrib><creatorcontrib>Minhas, Gunjeet</creatorcontrib><creatorcontrib>Collyer, Martin R.</creatorcontrib><creatorcontrib>Sterling, Michele</creatorcontrib><title>C-reactive protein (CRP) is associated with chronic pain independently of biopsychosocial factors</title><title>The journal of pain</title><addtitle>J Pain</addtitle><description>Inflammation is linked with chronic pain but the extent to which this relationship is associated with biopsychosocial factors is not known. We investigated relationships between blood C-reactive protein (CRP) and regional chronic pain conditions adjusting for a large range and number of potential confounders. We performed cross-sectional analyses using the UK Biobank (N=415,567) comparing CRP in people reporting any of nine types of regional chronic pain with pain-free controls. Using logistic regression modelling, we explored relationships between CRP and the presence of chronic pain, with demographic, socioeconomic, psychological/lifestyle factors, and medical comorbidities as covariates. CRP was higher in chronic pain at any site compared with controls (Females: median [IQR] 1.60mg/L [2.74] vs 1.17mg/L [1.87], P<0.001; Males: 1.44mg/L [2.12] vs 1.15mg/L [1.65], P<0.001). In males, associations between CRP and all types of chronic pain were attenuated but remained significant after adjustment for biopsychosocial covariates (OR range 1.08 to 1.49, P≤0.001). For females, adjusted associations between CRP and pain remained significant for most chronic pain types (OR range 1.07 to 1.34, P<0.001) except for facial pain (OR 1.04, P=0.17) and headache (OR 1.02, P=0.07)—although these non-significant findings may reflect reduced sample size. The significant association between CRP and chronic pain after adjustment for key biopsychosocial confounders implicates an independent underlying biological mechanism of inflammation in chronic pain. The presence of yet unknown or unmeasured confounding factors cannot be ruled out. Our findings may inform better targeted treatments for chronic pain.
Using a large-scale dataset, this article investigates associations between chronic pain conditions and blood C-reactive protein (CRP), to evaluate the confounding effects of a range of biopsychosocial factors. CRP levels were higher in those with chronic pain vs controls after adjusting for confounders—suggesting a possible independent biological mechanism.
•In the UK Biobank, chronic pain is associated with higher blood CRP levels•This association was attenuated but still significant after confounder adjustment•This may reflect a pathophysiologic role of systemic inflammation in chronic pain</description><subject>back pain</subject><subject>Biomarkers</subject><subject>C-reactive protein</subject><subject>C-Reactive Protein - analysis</subject><subject>C-Reactive Protein - metabolism</subject><subject>Chronic pain</subject><subject>Chronic Pain - complications</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Humans</subject><subject>inflammation</subject><subject>Inflammation - complications</subject><subject>Male</subject><subject>neck pain</subject><issn>1526-5900</issn><issn>1528-8447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LxDAQhoMofv8CQXLUQ-sk2TbtwYMsfoGgiJ5Dmk7YLN2mJl1l_73ZXfXoZWZg3nde5iHkjEHOgJVX83w-aNfnHLjIoc4Bqh1yyApeZdVkInc3c5kVNcABOYpxDsBYIeU-ORBSTtKSHxI9zQJqM7pPpEPwI7qeXkxfXy6pi1TH6I3TI7b0y40zambB987QdSx1fYsDptKP3Yp6Sxvnh7gyM78xddSmsz7EE7JndRfx9Kcfk_e727fpQ_b0fP84vXnKjCjqMRNotSgLkJKV2NTYWlZLy42YYFsJ0ZhKg9GW28aWwAoLNUoLWHABQjesFsfkYns3vfGxxDiqhYsGu0736JdR8aqsGC-FKJJUbKUm-BgDWjUEt9BhpRioNVs1Vxu2as1WQa0S2-Q6_wlYNgts_zy_MJPgeivA9Oanw6CicdgbbF1AM6rWu38DvgEyw4zD</recordid><startdate>202402</startdate><enddate>202402</enddate><creator>Farrell, Scott F.</creator><creator>Armfield, Nigel R.</creator><creator>Cabot, Peter J.</creator><creator>Elphinston, Rachel A.</creator><creator>Gray, Paul</creator><creator>Minhas, Gunjeet</creator><creator>Collyer, Martin R.</creator><creator>Sterling, Michele</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1772-2248</orcidid><orcidid>https://orcid.org/0000-0002-1369-1483</orcidid></search><sort><creationdate>202402</creationdate><title>C-reactive protein (CRP) is associated with chronic pain independently of biopsychosocial factors</title><author>Farrell, Scott F. ; Armfield, Nigel R. ; Cabot, Peter J. ; Elphinston, Rachel A. ; Gray, Paul ; Minhas, Gunjeet ; Collyer, Martin R. ; Sterling, Michele</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-3efa36507716eb9edf197f2c34ed833bc8a0caf2fbf6015f09e7f0e52303ab193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>back pain</topic><topic>Biomarkers</topic><topic>C-reactive protein</topic><topic>C-Reactive Protein - analysis</topic><topic>C-Reactive Protein - metabolism</topic><topic>Chronic pain</topic><topic>Chronic Pain - complications</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Humans</topic><topic>inflammation</topic><topic>Inflammation - complications</topic><topic>Male</topic><topic>neck pain</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Farrell, Scott F.</creatorcontrib><creatorcontrib>Armfield, Nigel R.</creatorcontrib><creatorcontrib>Cabot, Peter J.</creatorcontrib><creatorcontrib>Elphinston, Rachel A.</creatorcontrib><creatorcontrib>Gray, Paul</creatorcontrib><creatorcontrib>Minhas, Gunjeet</creatorcontrib><creatorcontrib>Collyer, Martin R.</creatorcontrib><creatorcontrib>Sterling, Michele</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of pain</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Farrell, Scott F.</au><au>Armfield, Nigel R.</au><au>Cabot, Peter J.</au><au>Elphinston, Rachel A.</au><au>Gray, Paul</au><au>Minhas, Gunjeet</au><au>Collyer, Martin R.</au><au>Sterling, Michele</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>C-reactive protein (CRP) is associated with chronic pain independently of biopsychosocial factors</atitle><jtitle>The journal of pain</jtitle><addtitle>J Pain</addtitle><date>2024-02</date><risdate>2024</risdate><volume>25</volume><issue>2</issue><spage>476</spage><epage>496</epage><pages>476-496</pages><issn>1526-5900</issn><eissn>1528-8447</eissn><abstract>Inflammation is linked with chronic pain but the extent to which this relationship is associated with biopsychosocial factors is not known. We investigated relationships between blood C-reactive protein (CRP) and regional chronic pain conditions adjusting for a large range and number of potential confounders. We performed cross-sectional analyses using the UK Biobank (N=415,567) comparing CRP in people reporting any of nine types of regional chronic pain with pain-free controls. Using logistic regression modelling, we explored relationships between CRP and the presence of chronic pain, with demographic, socioeconomic, psychological/lifestyle factors, and medical comorbidities as covariates. CRP was higher in chronic pain at any site compared with controls (Females: median [IQR] 1.60mg/L [2.74] vs 1.17mg/L [1.87], P<0.001; Males: 1.44mg/L [2.12] vs 1.15mg/L [1.65], P<0.001). In males, associations between CRP and all types of chronic pain were attenuated but remained significant after adjustment for biopsychosocial covariates (OR range 1.08 to 1.49, P≤0.001). For females, adjusted associations between CRP and pain remained significant for most chronic pain types (OR range 1.07 to 1.34, P<0.001) except for facial pain (OR 1.04, P=0.17) and headache (OR 1.02, P=0.07)—although these non-significant findings may reflect reduced sample size. The significant association between CRP and chronic pain after adjustment for key biopsychosocial confounders implicates an independent underlying biological mechanism of inflammation in chronic pain. The presence of yet unknown or unmeasured confounding factors cannot be ruled out. Our findings may inform better targeted treatments for chronic pain.
Using a large-scale dataset, this article investigates associations between chronic pain conditions and blood C-reactive protein (CRP), to evaluate the confounding effects of a range of biopsychosocial factors. CRP levels were higher in those with chronic pain vs controls after adjusting for confounders—suggesting a possible independent biological mechanism.
•In the UK Biobank, chronic pain is associated with higher blood CRP levels•This association was attenuated but still significant after confounder adjustment•This may reflect a pathophysiologic role of systemic inflammation in chronic pain</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37741522</pmid><doi>10.1016/j.jpain.2023.09.008</doi><tpages>21</tpages><orcidid>https://orcid.org/0000-0003-1772-2248</orcidid><orcidid>https://orcid.org/0000-0002-1369-1483</orcidid></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | back pain Biomarkers C-reactive protein C-Reactive Protein - analysis C-Reactive Protein - metabolism Chronic pain Chronic Pain - complications Cross-Sectional Studies Female Humans inflammation Inflammation - complications Male neck pain |
| title | C-reactive protein (CRP) is associated with chronic pain independently of biopsychosocial factors |
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