Kahan Riley, Woznowski-Vu Arthur, Huebner Janet L, Pieper Carl F, Goode Adam P, George Steven Z, Wideman Timothy H, Kraus Virginia Byers, Colón-Emeric Cathleen, Simon Corey B
Department of Surgery, Duke University School of Medicine, Durham, NC, USA.
School of Physical & Occupational Therapy, McGill University, Montreal, QC, Canada.
Pain Rep. 2025 Apr 3;10(3):e1262. doi: 10.1097/PR9.0000000000001262. eCollection 2025 Jun.
Low back pain (LBP) is a leading global factor in disability among older adults. Movement-evoked pain (MEP) is potentially an important mediator in the disability pathway but is predominantly tested in the laboratory.
We aimed to explore MEP in the natural environment ("daily" MEP) and its correlation with laboratory MEP, along with potential psychological and immunological influences.
Thirty-five older adults with persistent LBP attended a single laboratory session. Pain catastrophizing, pain-related fear of movement, and pain self-efficacy were measured by questionnaire. Resting inflammation and inflammatory reactivity to painful movement were evaluated using serum interleukin-6, tissue necrosis factor alpha, and C-reactive protein (CRP). Laboratory MEP was defined by aggregate pain intensity with a movement provocation test. Daily MEP was measured for the next 7 days using ecological momentary assessment.
Laboratory MEP was strongly correlated with daily MEP ( = 0.780, = <0.001). C-reactive protein (Hedges [] = 0.266) and interleukin-6 (g = 0.433) demonstrated small to moderate reactivity to painful movement. After controlling for age and multimorbidity, pain catastrophizing and pain self-efficacy explained 24% to 37% variance in laboratory and daily MEP. Resting inflammatory markers were not associated with MEP; however, C-reactive protein reactivity to painful movement explained 19% to 25% variance in laboratory and daily MEP.
Preliminary indication is that laboratory and daily MEP may be proxy measures for one another, and that MEP is influenced by psychological and immunological factors. Future studies will aim to (1) validate findings among older adults with persistent LBP and (2) for clinical phenotyping, clarify complex relationships among psychological and immunological factors with disability pathway components like MEP.
下背痛（LBP）是全球老年人残疾的主要因素。运动诱发疼痛（MEP）可能是残疾途径中的一个重要中介因素，但主要在实验室中进行测试。
我们旨在探索自然环境中的MEP（“日常”MEP）及其与实验室MEP的相关性，以及潜在的心理和免疫影响。
35名患有持续性LBP的老年人参加了一次实验室检查。通过问卷测量疼痛灾难化、与疼痛相关的运动恐惧和疼痛自我效能感。使用血清白细胞介素-6、肿瘤坏死因子α和C反应蛋白（CRP）评估静息炎症和对疼痛运动的炎症反应性。实验室MEP通过运动激发试验的总疼痛强度来定义。在接下来的7天内使用生态瞬时评估法测量日常MEP。
实验室MEP与日常MEP密切相关（ = 0.780， = <0.001）。C反应蛋白（Hedges [] = 0.266）和白细胞介素-6（g = 0.433）对疼痛运动表现出小到中度的反应性。在控制年龄和多种疾病后，疼痛灾难化和疼痛自我效能感解释了实验室和日常MEP中24%至37%的方差。静息炎症标志物与MEP无关；然而，C反应蛋白对疼痛运动的反应性解释了实验室和日常MEP中19%至25%的方差。
初步迹象表明，实验室和日常MEP可能互为替代指标，且MEP受心理和免疫因素影响。未来的研究旨在（1）在患有持续性LBP的老年人中验证研究结果，以及（2）对于临床表型分析，阐明心理和免疫因素与残疾途径组成部分（如MEP）之间的复杂关系。
