Low-grade Inflammation May Moderate the Effect of Behavioral Treatment for Chronic Pain in Adults

J Behav Med. 2016 Oct;39(5):916-24. doi: 10.1007/s10865-016-9769-z. Epub 2016 Jul 28.


The purpose of the present pilot study was to explore the moderating role of basal inflammation on the effects of behavioral pain treatment in 41 patients with long-standing pain. Baseline pro-inflammatory status moderated behavioral treatment outcomes: higher pre-treatment levels of Tumor Necrosis Factor (TNF)-α and Interleukin (IL)-6 were related to less improvement in pain intensity, psychological inflexibility and in mental health-related quality of life. The treatment outcomes improved in the subgroup that had low levels of pro-inflammatory cytokines at baseline, while the subjects with higher pro-inflammatory status did not. Altogether, results indicate that low-grade inflammation may influence the behavioral treatment outcomes and provide a possible explanation of the heterogeneity in treatment response.

Keywords: Chronic low-grade inflammation; Chronic pain; Cognitive behavioral therapy (CBT); Cytokines; Psychological inflexibility; Treatment responders.

MeSH terms

  • Adult
  • Behavior Therapy / methods*
  • Chronic Pain / metabolism*
  • Chronic Pain / psychology
  • Chronic Pain / therapy*
  • Female
  • Humans
  • Inflammation / metabolism*
  • Interleukin-6 / metabolism
  • Male
  • Middle Aged
  • Pain Management
  • Pilot Projects
  • Quality of Life*
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / metabolism


  • IL6 protein, human
  • Interleukin-6
  • Tumor Necrosis Factor-alpha