hs-CRP — Does inflammation occur in people with chronic lower back pain?
Many people think of chronic lower back pain as being due to something damaged in or around their spine. Research is very clear that this isn’t the case.
In fact, in long-standing back pain (one year and longer) nothing is damaged at all!
The tissues have healed.
What’s in play is a disruption in the way your brain is registering the signals being input from the body. It starts to view safe signals as dangerous. When the brain perceives certain nerve signals to be dangerous — it projects pain to that area.
Watch pain expert Lorimer Moseley explain the illusion of chronic pain on TEDx
It’s like an optical illusion. The difference being, it’s a very real experience to the recipient.
But with acute lower back pain (typically less than 6–8 months), you are dealing with damage and inflammation.
Local inflammatory processes play an important role in patients with acute lumbosciatic pain (back pain that goes down your leg).
What were they trying to figure out?
Researchers wanted to assess the value of erythrocyte sedimentation rate (ESR) and high sensitivity C-reactive protein (hs-CRP) measurements in patients with chronic low back pain or radiculopathy.
In other words, they wanted to see the value of ESR and/or hs-CRP and figure out if inflammation existed in patients with chronic low back pain or radicular acute lower back pain. Radicular acute lower back pain — that also back pain that goes down the leg.
BTW — This test was done in 2010, even though the new pain theory had been proven — it didn’t become more widely known for around 7 more years.
The problem is — this new explanation of pain — ruins many healthcare business models. So many doctors will ignore the research to keep the cash cow alive.
Moving on…
hs-CRP measures inflammation in the body. ESR is more of a non-specific tracker of inflammation. It’s a common blood test that tracks how quickly red blood cells settle at the bottom of a test tube that contains a blood sample.
Normally, red blood cells settle relatively slowly. If they settle faster than they should, then that may indicate inflammation in the body.
How They Did It & What They Found (Summarized)
ESR and hs-CRP were measured in 273 blood samples from male and female subjects with low back pain and/or radiculopathy due to herniated lumbar disc, spinal stenosis, facet syndrome, and other diseases. The hs-CRP and ESR were measured prior to lumbar epidural steroid injection.
hs-CRP can be beneficial for uncovering early heart disease. Check your hs-CRP from home.
What they found was that a significant systemic inflammatory reaction did not appear to arise in patients with chronic low back pain.
Inflammation isn’t there
As a side note another study done in 2006, four years earlier — found the following:
“In conclusion, according to this study levels of hsCRP do not have a major clinical relevance when evaluating the long-term course of patients with acute lumbosciatic pain and chronic low back pain and therefore should not be taken into primary consideration when decisions on therapy are made.”
Take away point — chronic lower back pain isn’t an inflammatory process — its a crossing of the wiring!
Chronic pain is someone ringing your doorbell but instead of your house — it rings every other house in the neighborhood!
Not fun and very difficult to treat.
