The role of TNF-alpha in patients with chronic low back pain-a prospective comparative longitudinal study

Clin J Pain. 2008 Mar-Apr;24(3):273-8. doi: 10.1097/AJP.0b013e31816111d3.


Objectives: In this prospective longitudinal clinical study with a matched-pair design, we evaluated the role of tumor necrosis factor-alpha (TNF-alpha) and its clinical relevance in patients with chronic low back pain.

Methods: One hundred twenty patients with chronic low back pain were matched to a healthy control group. Patients and controls were prospectively followed for 6 months. At 4 fixed time points (day 0, day 10, day 20, and 6 mo) blood samples were taken and TNF-alpha levels compared in the 2 groups, and correlations with pain level and clinical function were analyzed.

Results: At the beginning and at all other time points, there was a significantly higher proportion of TNF-alpha positive participants in the patients group than in the control group. The proportion of TNF-alpha positive patients decreased during the first 10 days of a multidisciplinary therapy in the patient group, but after this initial period, TNF-alpha levels remained constantly high with no further change until the final follow-up. In the healthy control group, the proportion of participants with positive TNF-alpha levels remained constant throughout the entire period. No significant correlation between TNF-alpha levels and pain or clinical function was detected.

Discussion: TNF-alpha seems to have a significant role in patients with chronic low back pain. However, the pathophysiology of this process, the clinical relevance of TNF-alpha and, especially, its part in a potential therapy regimen in these patients need to be more closely examined and defined in additional studies.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Case-Control Studies
  • Chronic Disease
  • Disability Evaluation
  • Female
  • Humans
  • Longitudinal Studies
  • Low Back Pain / blood*
  • Low Back Pain / physiopathology
  • Low Back Pain / therapy*
  • Male
  • Middle Aged
  • Pain Measurement
  • Statistics as Topic
  • Time Factors
  • Tumor Necrosis Factor-alpha / blood*


  • Tumor Necrosis Factor-alpha