Approved Research

Mental well-being, markers of systemic inflammation, and physical activity in acute and chronic back pain

Lay summary

Back pain is the leading cause of years lived with a disability worldwide, impacting approximately 7.1% of the global population. Approximately 80% of adults experience an episode of back pain at some point in their lives, meaning that the reality of most adults is not whether they will experience back pain, but rather when. This high lifetime prevalence of back pain is of particular concern, because for up to 25%, the pain will persist longer than 12 weeks and thus become chronic. For the majority of people with back pain (90%), a specific cause cannot be identified. However, certain factors have been found which are associated with the condition and interact with each other. These factors include poor well-being, which is linked to higher levels of systemic inflammation, and lower levels of physical activity. Regular physical activity can improve both inflammation and well-being, but data on relative contributions and directionality remain scarce. Based on this, back pain can be regarded as a multidimensional problem which is influenced by biological, psychological, and social factors, but research commonly examines these factors independently. A better understanding of the potential factors associated with back pain as underlying drivers of different back pain groups could lead to an improved screening of patients, and consequently to a more specific and effective treatment. Therefore, the aim of this project is to identify relative contributions of mental well-being, systemic inflammation, and physical activity across individuals with acute back pain, chronic localised back pain, and chronic widespread pain compared to individuals with no pain.

The expected duration of this project is up to 24 months. A considerable public health impact can be assumed by this project, as for 90% of people suffering from back pain, underlying causes and treatment recommendations can currently not further be differentiated. This leads to a number of treatment options that have shown some positive effect on people with back pain, but the magnitude of these treatment effects remains at best modest. By evaluating relative contributions of multiple factors associated with back pain using a large sample, future management strategies could be based on a more specific screening of back pain patients and result in an individualised, targeted and finally more effective treatment. This could reduce the substantial individual and socioeconomic burden of back pain as well as diminish disability of those affected.