Chronic Low Back Pain, Sleep Disturbance, and Interleukin-6

Abstract

Objectives Sleep disturbance is a common co-morbidity of chronic pain. Inflammatory processes are dysregulated in sleep disturbance and also contribute to pain sensitivity. Thus, inflammation may play an important role in bi-directional associations between pain and sleep. Little is known about concurrent relationships among chronic pain, sleep, and inflammation. The aim of our study was to examine associations among sleep disturbance and circulating levels of the inflammatory cytokine, interleukin-6 (IL-6), in individuals with and without chronic low back pain. Methods Gender and age-matched adults with chronic low back pain (CLBP; n = 25) or without chronic pain (controls; n = 25) completed measures of sleep quality in the past month and depressive symptoms in the past week, and provided a blood draw for IL-6. The next morning, participants reported their sleep quality the previous night and their current experience of morning pain. Results Individuals with CLBP had more sleep disturbance than controls. Circulating IL-6 levels were similar for the two groups; however, in adults with CLBP, poorer sleep quality was associated with higher IL-6 levels, and both sleep and IL-6 related to pain reports. Unlike CLBP participants, controls showed normal, age-related increases in IL-6 levels, whereas sleep quality was unrelated to IL-6 levels. Depressive symptoms could not fully explain the observed associations. Discussion Inflammatory processes may play a significant role in cycles of pain and sleep disturbance. Clinical interventions that improve sleep and reduce concomitant inflammatory dysregulation hold promise for chronic pain management.

The Importance of Night Pain for the Effectiveness of Theurapotic Ultrasound in the Sub acromial Impingement Syndrome: A Randomized Controlled Trial

“…A large number of studies comparing ultrasound with other physical treatment modalities or with placebos have reported that it reduces shoulder pain during activity at rest and at night [5][6][7][8]. In contrast other studies have reported that treating shoulder pathologies with ultrasound is no more effective than using a placebo [9].…”

“…A meta-analysis reported that ultrasound therapy was not effective in treating shoulder pathologies [9]. All treatment groups, including those patients receiving ultrasound therapy improved but did not differ from the placebo groups.…”

“…A study that compared NSAIDs with placebo found that acute shoulder pain decreased within 1-2 weeks [22]. The effectiveness of corticosteroid injections also indicates that inflammation is involved in SIS pathology [9,13]. All patients included in our study were prescribed 15 mg of meloxicam and 30 mg of lansoprazole once per day during the first month of treatment.…”

“…Studies on the efficacy of ultrasound therapy in treating SIS have produced conflicting results [5][6][7][8][9]. A large number of studies comparing ultrasound with other physical treatment modalities or with placebos have reported that it reduces shoulder pain during activity at rest and at night [5][6][7][8].…”

“…It's known that inflammation causes night paint and sleep disturbance in lots of painful pathologies [9]. Because by the increment of severity of the pathology in SIS, night pain emerges; it is thought that patients with night pain have more inflammation and carries acute characteristics [2].…”