Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr 15;17(4):e0266999.
doi: 10.1371/journal.pone.0266999. eCollection 2022.

An exploratory identification of biological markers of chronic musculoskeletal pain in the low back, neck, and shoulders

Codjo Djignefa Djade  1   2   3 , Caroline Diorio  1   2 , Danielle Laurin  2   3   4 , Clermont E Dionne  1   2   3   5
Affiliations

An exploratory identification of biological markers of chronic musculoskeletal pain in the low back, neck, and shoulders

Codjo Djignefa Djade et al. PLoS One. .

Abstract

Objectives: This study was an in-depth exploration of unique data from a nationally representative sample of adults living in the United States to identify biomarkers associated with musculoskeletal pain.

Methods: We performed secondary analyses of 2003-2004 NHANES data. After a first screening of 187 markers, analyses of 31 biomarkers were conducted on participants aged ≥20 years identified in all counties using the 2000 Census Bureau data (n = 4,742). To assess the association of each biomarker with each pain outcome (acute, subacute and chronic low back, neck, and shoulder pain), analyses were carried out using multivariable logistic regression with adjustments for sex, age and body mass index. Biomarkers were considered as continuous variables and categorized at the median of their distributions.

Results: Pain at any site for ≥24 hours during the past month was reported by 1,214 participants. Of these, 779 mentioned that the pain had lasted for ≥3 months ("chronic pain"). α-carotene, ascorbic acid, β-carotene, mercury and total protein had a statistically significant, inverse association with ≥2 chronic pain sites. Acrylamide, alkaline phosphatase, cadmium, cotinine, glycidamide, homocysteine, retinol, triglycerides and white blood cell count were positively associated with ≥2 chronic pain sites. Few biological markers were associated with acute and subacute pain.

Conclusions: This study identified some biomarkers that were strongly and consistently associated with musculoskeletal pain. These results raise new hypotheses and could have tremendous implications for advancing knowledge in the field. Research on musculoskeletal pain needs to put more effort on the biological dimension of the biopsychosocial model of pain.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Selection of study participants.
N.B: The number of participants with pain includes all pain sites included in NHANES 2003–2004. The question on pain includes all sites of musculoskeletal pain (shoulder, arm, low back, leg, neck, spine, hand, foot…).
See this image and copyright information in PMC

References

    1. Hoy DG, Smith E, Cross M, Sanchez-Riera L, Buchbinder R, Blyth FM, et al.. The global burden of musculoskeletal conditions for 2010: an overview of methods. Ann Rheum Dis. 2014;73(6):982–9. Epub 2014/02/20. doi: 10.1136/annrheumdis-2013-204344 . - DOI - PubMed
    1. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736–47. doi: 10.1016/S0140-6736(16)30970-9 . - DOI - PubMed
    1. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al.. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2197–223. doi: 10.1016/S0140-6736(12)61689-4 . - DOI - PubMed
    1. Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al.. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73(6):968–74. doi: 10.1136/annrheumdis-2013-204428 . - DOI - PubMed
    1. Waddell G. 1987 Volvo award in clinical sciences. A new clinical model for the treatment of low-back pain. Spine (Phila Pa 1976). 1987;12(7):632–44. Epub 1987/09/01. doi: 10.1097/00007632-198709000-00002 . - DOI - PubMed