A question I asked myself recently was, “Is there a connection between muscle pains and C-reactive protein?” C-reactive protein is a protein found within the blood that is a measure of general levels of inflammation. C-reactive protein is often a tested used to assess for infection or diseases that cause inflammation such as lymphoma, lupus, giant cell arteritis, rheumatoid arthritis, inflammatory bowel disease, osteomyelitis. Here is some of the research that I have found on musculoskeletal pain and pain sensation as it relates to C-reactive protein.
T Sturmer, E Raum, M Buchner, K Gebhardt, M Schiltenwolf, W Richter,
Background: The severity of pain from musculoskeletal disorders might be associated with high sensitivity C reactive protein (hsCRP), a sensitive marker of low grade systemic inflammation.
Objective: To study the association between pain as assessed by a visual analogue scale (VAS) and hsCRP in patients with chronic low back pain and acute sciatic pain.
Methods: Information on pain severity, determinants of hsCRP, and hsCRP values were obtained prospectively at up to 10 time points during six months in 72 consecutive patients (mean age 43.3 years; 59.7% female): 41 with chronic low back pain and 31 with acute sciatic pain. The association between severity of pain and raised (highest quartile) hsCRP values at any time point was estimated by multivariable logistic regression using generalised estimating equations to adjust odds ratios (OR) and their confidence intervals (CI) for intraindividual dependence of measurements.
Results: Mean intensity of pain (VAS 0–10) at baseline was 4.9 and 5.5 in patients with chronic low back and acute sciatic pain, respectively. Highest v lowest tertile of average intensity of pain during the last 24 hours was associated with increased hsCRP levels among patients with acute sciatic pain (adjusted OR = 3.4 (95% CI, 1.1 to 10), but not in patients with chronic low back pain (adjusted OR = 0.87 (0.25 to 3.0)).
Conclusions: Mean intensity of pain during the previous 24 hours as assessed by VAS was independently associated with high levels of hsCRP in patients with acute sciatic pain but not in those with chronic low back pain.
Elevated serum high-sensitivity C-reactive protein levels in fibromyalgia syndrome patients correlate with body mass index, interleukin-6, interleukin-8, erythrocyte sedimentation rate
Yangming Xiao, Wanda L. Haynes, Joel E. Michalek, I. Jon Russell
The levels of several inflammatory cytokines are abnormal in many patients with the fibromyalgia syndrome (FMS) and may play a role in its pathogenesis. The inflammatory marker C-reactive protein (CRP) is associated with the disease activity in patients with inflammatory rheumatic diseases, but its role in FMS is unknown. We undertook this study to determine whether high-sensitivity CRP (hsCRP) is elevated in FMS and whether its levels relate to key biologic or clinical measures. One hundred and five patients with FMS (1990 ACR criteria) and 61 healthy normal controls (HNC) at a ratio of 2:1 were recruited. The serum concentrations of hsCRP, interleukin-8 (IL-8), and interleukin-6 (IL-6) were assessed using enzyme-linked immunosorbent assays. The hsCRP levels were marginally higher in FMS than in HNC (p = 0.06) and its abnormality rate (>1.5 SD above the HNC mean) was significantly higher in FMS (25 %) compared with HNC (6.8 %) (p = 0.03). Serum IL-8 levels, IL-6 levels, and erythrocyte sedimentation rate (ESR) in FMS did not differ from those in HNC. Body mass index (BMI), ESR, IL-8, and IL-6 levels correlated with hsCRP levels in FMS. No associations were found between hsCRP and age, gender, ethnicity, or other clinical measures. Serum CRP levels were higher in FMS and significantly correlated with BMI, ESR, IL-8, and IL-6 levels, suggesting that inflammation may contribute to the symptoms in some FMS patients, particularly those who are obese. Weight loss and therapies directed against inflammation may be useful in the management of FMS patients with elevated hsCRP.
The Relationships of C-Reactive Protein and Obesity to the Prevalence and the Odds of Reporting Low Back Pain
Matthew S. Briggs, DPT , Deborah L. Givens, PhD, DPT, Laura C. Schmitt, PhD, MPT, Chris A. Taylor, PhD, RD
Objective: To assess the odds of reporting low back pain (LBP) as related to systemic inflammation and obesity. It was hypothesized that obesity and systemic inflammation would increase the odds of reporting LBP.
Design Cross-sectional analysis of the 1999-2004 National Health and Nutrition Examination Survey (NHANES).
Setting National database analysis.
Participants Population-based sample of 15,322 participants in the 1999-2004 NHANES databases.
Main Outcome Measures
Systemic inflammation was measured by C-reactive protein (CRP) and fibrinogen. Obesity was quantified by body mass index (BMI) and waist circumference (WC). LBP was identified by self-report. Analysis included logistic regression to assess the odds of reporting LBP as related to systemic inflammation and obesity.
Results
Participants with elevated CRP (>3.0 mg/dL) had 1.74(CI:1.04-2.91) greater odds of reporting LBP. Those who were obese (> 30 kg/m 2 ) with elevated CRP had 2.87(CI: 1.18-6.96) greater odds of reporting LBP than those without elevated CRP. When using WC as the measure of obesity, participants with high WC values had a significantly greater odds of reporting LBP [OR: 2.39 (CI: 1.09-5.21)]
Conclusion
To our knowledge, this is the first study showing that high levels of CRP may increase the odds of reporting LBP especially in those who are obese. These findings warrant further investigation of the inter-relationships among obesity, systemic inflammation and LBP.
C-Reactive Protein and Pain Sensitivity: Findings from Female Twins
Niloofar Afari, PhD, Sheeva Mostoufi, BS, Carolyn Noonan, MS, Brian Poeschla, MD, Annemarie Succop, BA, Laura Chopko, BA, and Eric Strachan, PhD
Background
Systemic inflammation and pain sensitivity may contribute to the development and maintenance of chronic pain conditions.
Purpose
We examined the relationship between systemic inflammation as measured by C-reactive protein (CRP), and cold pain sensitivity in 198 female twins from the University of Washington Twin Registry. We also explored the potential role of familial factors in this relationship.
Methods
Linear regression modeling with generalized estimating equations examined the overall and within-pair associations.
Results
Higher levels of CRP were associated with higher pain sensitivity ratings at pain threshold (p = 0.02) and tolerance (p = 0.03) after adjusting for age, body mass index, time to reach pain threshold or tolerance, and clinical pain status. The magnitude of the associations remained the same in within-pair analyses controlling for familial factors.
Conclusions
The link between CRP and pain sensitivity may be due to non-shared environmental factors. CRP and pain sensitivity can be examined as potential biomarkers for chronic pain and other inflammatory conditions.
Dr Notley’s Conclusion.
There seems to be some connection between C-reactive protein and musculoskeletal pain/pain sensitivity. Using appropriate methods to reduce C-reactive protein may help with some musculoskeletal problems and pain sensitivity. What are those methods? Some more research is needed.
Dr Notley
Winnipeg Chiropractor and Athletic Therapist
Originally posted on May 17, 2022 @ 4:37 pm
