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Role of tumor necrosis factor a (TNFa) in Chronic Low Back Pain

The authors evaluated the role of tumor necrosis factor a, TNFa, in patients with low back pain. Inflammatory cytokines such as TNFa are known to play a role in central and peripheral pain perception. The authors chose to evaluate the presence and level of TNFa in subjects with chronic low back pain. Upon entry to the study, 56 percent of the subjects with chronic low back pain versus 12 percent of the healthy control group were positive for TNFa. The TNFa level was evaluated four times over the course of six months.

While the levels decreased in those with chronic low back pain after participating in a multidisciplinary treatment initially, they remained higher than the control group over the six month period. Even when pain and function improved in the chronic low back pain group, the TNFa level did not significantly decrease as might be expected. Therefore, the authors do not feel that the presence or level of TNFa is useful as a predictor of the clinical course in patients with low back pain. The clinical relevance of the findings are uncertain. They do feel that treatment targeting TNFa may be worth further exploration.

References: H. Wang, M. Schiltenwolf, M. Buchner. The Role of TNFa in Patients With Chronic Low Back Pain: A Prospective Comparative Longitudinal Study. Clin J Pain. 2008. Vol. 24, Num. 3. Pp. 273-278.

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