Acute, Chronic Pain and Its Association with Serum Interleukin-6 and Highly Sensitive C Reactive Protein in Patients with Cervical or Lumbar Disc Herniation
JavaScript is disabled for your browser. Some features of this site may not work without it.
Acute, Chronic Pain and Its Association with Serum Interleukin-6 and Highly Sensitive C Reactive Protein in Patients with Cervical or Lumbar Disc Herniation
Imrana, M. F.; Priyankara, H. G. R.; Withanage, N. D.; Attanayake, D.; Dias, P.; Athiththan, L. V.
Citation:Imrana, M. F. , Priyankara, H. G. R. , Withanage, N. D. , Attanayake, D. , Dias, P. , & Athiththan, L. V. (2020). Acute, Chronic Pain and Its Association with Serum Interleukin-6 and Highly Sensitive C Reactive Protein in Patients with Cervical or Lumbar Disc Herniation. 3rd Research Symposium of the Faculty of Allied Health Sciences, University of Ruhuna, Galle, Sri Lanka, 36.
Date:2020-10-02
Abstract:
Background: Intervertebral Disc Herniation (IDH) that occurs mainly in the lumbar and
cervical region of the spine is a common cause for radiculopathy and associated pain. IDH is
often accompanied by acute and chronic pain. Inflammation is a major cause for radiculopathy
and such local inflammation caused by Interleukin-6 (IL-6) which is believed to be a pro inflammatory marker in C-reactive protein (CRP) production. CRP is the first acute phase
protein to appear and is a sensitive marker of tissue damage and local inflammation. However,
in radiculopathy, subtle changes in local inflammation may not be detected in routine CRP
analysis, therefore, highly sensitive CRP (hs-CRP) would be a better indicator in IDH.
Objectives: To assess the pain duration (acute/chronic) and its association with IL-6 and hs CRP in patients with cervical disc herniation (CDH) or lumbar disc herniation (LDH)
Methods: A descriptive cross-sectional study was conducted using 77 patients (18-70 years)
with either CDH or LDH. Venous blood (5 mL) was collected and hs-CRP was analyzed by
automated clinical analyzer while IL-6 was estimated by Enzyme Linked Immunosorbent
Assay. Subjects with neck/back pain for >3 months were regarded as acute pain patients
whereas subjects with persisted pain for <3 months were categorized as chronic patients.
Mann-Whitney U test was used for statistical analysis and p <0.05 was considered as
significant.
Results: Majority of the patients presented with LDH (64.9%). Highest percentage had chronic
pain (62.3%), whereas the remaining suffered from acute pain. Patients with chronic neck/back
pain showed significantly (p = 0.04) higher IL-6 level (mean rank= 40.9 pg/mL) compared to
patients with acute neck/back pain (mean rank= 30.35 pg/mL). Hs-CRP level was higher in
patients with acute neck/back pain (mean rank= 42.5 mg/L) compared to that of patients with
chronic neck/back pain (mean rank= 36.8 mg/L) which did not show significant difference (p =
0.28) among the study groups of acute and chronic pain. There was no significant correlation
between serum IL-6 and hs-CRP levels (r = 0.02, p ˃0.05).
Conclusions: Present study showed increased level of hs-CRP in patients with acute neck/back
pain as an initial response to inflammation around nerve roots. However, IL-6 levels were
higher in patients with chronic neck/back pain recommending further investigations with other
similar pro-inflammatory markers with duration of pain. There was no significant correlation
between serum IL-6 and hs-CRP levels.