Up-regulation of circulating microRNA-17 is associated with lumbar radicular pain following disc herniation

Background: Previous studies suggest that regulatory microRNAs (miRs) may modulate neuro-inflammatory processes. The purpose of the present study was to examine the role of miR-17 following intervertebral disc herniation. Methods: In a cohort of 97 patients with leg pain and disc herniation verified on MRI, we investigated the association between circulating miR-17 and leg pain intensity. A rat model was used to examine possible changes in miR-17 expression in nucleus pulposus (NP) associated with leak of NP tissue out of the herniated disc. The functional role of miR-17 was addressed by transfection of miR-17 into THP-1 cells (human monocyte cell line). Results: An association between the level of miR-17 in serum and the intensity of lumbar radicular pain was shown. Up-regulation of miR-17 in the rat NP tissue when applied onto spinal nerve roots and increased release of TNF following transfection of miR-17 into THP-1 cells were also observed. Hence, our data suggest that miR-17 may be involved in the pathophysiology underlying lumbar radicular pain after disc herniation. Conclusions: We conclude that miR-17 may be associated with the intensity of lumbar radicular pain after disc herniation, possibly through a TNF-driven pro-inflammatory mechanismUp-regulation of circulating microRNA-17 is associated with lumbar radicular pain following disc herniationpublishedVersio

Eivind Hasvik's Quick Files

The Quick Files feature was discontinued and it’s files were migrated into this Project on March 11, 2022. The file URL’s will still resolve properly, and the Quick Files logs are available in the Project’s Recent Activity

PainDETECT did not detect neuropathic pain in painful low back radiculopathies

Poster presentation for 6th NeuPSIG Congress, Gothenburg, Sweden, June 15-18, 2017

Eivind Hasvik's Quick Files

The Quick Files feature was discontinued and it’s files were migrated into this Project on March 11, 2022. The file URL’s will still resolve properly, and the Quick Files logs are available in the Project’s Recent Activity

Subjective health complaints in patients with lumbar radicular pain and disc herniation are associated with a sex - OPRM1 A118G polymorphism interaction: a prospective 1-year observational study

Background Earlier observations show that development of persistent pain may be associated with the genetic variability in the gene encoding for the μ-opioid receptor 1, the OPRM1 A118G (rs1799971). The aim of this study was to investigate the association between OPRM1 genotype and subjective health complaints in patients with radicular pain and disc herniation. Methods A prospective, 1-year observational study was conducted at a hospital back clinic, including 118 Caucasian patients with lumbar radicular pain and MRI confirmed disc herniation. Single nucleotide polymorphism genotyping regarding the OPRM1 A118G was performed. The data of individuals with AA versus AG or GG were analysed separately by linear mixed models. The Subjective Health Complaints Inventory (0-81) including 27 common complaints experienced the previous month on a scale from not at all (0) to severe (3) was used as outcome. Pain, prior duration of leg pain, age, smoking status, and lumbar disc surgery were considered as covariates. Results In total 23 of 118 patients were carriers of the OPRM1 G-allele. All patients except female carriers of the G-allele reported a decrease in pain from baseline to 1 year. Female carriers of the G-allele reported significantly higher subjective health complaints score during the study time span than male carriers of the G-allele when controlling for pain and pain duration. Conclusion The present data indicate that, when controlling for pain intensity and duration, subjective health complaints are associated with a sex - OPRM1 A118G polymorphism interaction in patients with radicular pain

Symptom descriptors and patterns in lumbar radicular pain caused by disc herniation: a 1-year longitudinal cohort study

ObjectiveThe objective of the present study was to explore the diversity, quality, severity and distribution of symptoms in patients with radicular pain and a lumbar disc herniation.DesignLongitudinal cohort study.SettingHospital-based back clinic.ParticipantsNinety patients referred to secondary healthcare with (a) low back-related leg pain, (b) age between 18 and 65 years and (c) MRI confirmed lumbar disc herniation at a relevant side and level.Outcome measuresNeuropathic pain symptoms were assessed using the Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2) and the painDETECT Questionnaire. In a subsample classified with neuropathic pain, in-depth interviews were performed, and symptomatic areas were drawn on standardised body charts.ResultsAt baseline, the most frequently used painDETECT symptom descriptor was numbness sensation, reported by 94%, followed by sudden pain attacks and tingling or prickling. The mean (SD) SF-MPQ-2 score (0–10) for aching pain was 5.9 (2.8); numbness 4.3 (3.3); tingling 4.0 (3.4); burning 2.6 (3.1); pain caused by light touch 1.5 (2.6). Leg pain was rated as extremely bothersome by 73%, numbness and tingling by 38%, weakness by 24% and back pain by 17%. In the subsample (n=52), deep-lying pain and non-painful abnormal sensations were frequent, at 71% and 85%. Drawings demonstrated substantial overlap between symptoms from compromised L5 and the S1 nerve roots. Painful and non-painful symptoms improved at approximately the same rate. At the 1-year follow-up, 45% (14/31) of patients who had received disc surgery, and 34% (18/53) of those who had received conservative treatment reported no bothersome back pain, leg pain, numbness/tingling or weakness.ConclusionPatients reported several highly bothersome symptoms, but not all are described as painful. The overall symptom profile of lumbar disc-related radicular pain differs from other neuropathic pain conditions with limited allodynia and thermal hyperalgesia. Symptomatic areas for the L5 and S1 nerve roots have a large overlap.</jats:sec

Symptom descriptors and patterns in lumbar radicular pain caused by disc herniation: a 1-year longitudinal cohort study

Objective The objective of the present study was to explore the diversity, quality, severity and distribution of symptoms in patients with radicular pain and a lumbar disc herniation.Design Longitudinal cohort study.Setting Hospital-based back clinic.Participants Ninety patients referred to secondary healthcare with (a) low back-related leg pain, (b) age between 18 and 65 years and (c) MRI confirmed lumbar disc herniation at a relevant side and level.Outcome measures Neuropathic pain symptoms were assessed using the Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2) and the painDETECT Questionnaire. In a subsample classified with neuropathic pain, in-depth interviews were performed, and symptomatic areas were drawn on standardised body charts.Results At baseline, the most frequently used painDETECT symptom descriptor was numbness sensation, reported by 94%, followed by sudden pain attacks and tingling or prickling. The mean (SD) SF-MPQ-2 score (0–10) for aching pain was 5.9 (2.8); numbness 4.3 (3.3); tingling 4.0 (3.4); burning 2.6 (3.1); pain caused by light touch 1.5 (2.6). Leg pain was rated as extremely bothersome by 73%, numbness and tingling by 38%, weakness by 24% and back pain by 17%. In the subsample (n=52), deep-lying pain and non-painful abnormal sensations were frequent, at 71% and 85%. Drawings demonstrated substantial overlap between symptoms from compromised L5 and the S1 nerve roots. Painful and non-painful symptoms improved at approximately the same rate. At the 1-year follow-up, 45% (14/31) of patients who had received disc surgery, and 34% (18/53) of those who had received conservative treatment reported no bothersome back pain, leg pain, numbness/tingling or weakness.Conclusion Patients reported several highly bothersome symptoms, but not all are described as painful. The overall symptom profile of lumbar disc-related radicular pain differs from other neuropathic pain conditions with limited allodynia and thermal hyperalgesia. Symptomatic areas for the L5 and S1 nerve roots have a large overlap

Primary Bone Marrow Edema Syndrome, a prospective observational study

Primary bone marrow edema syndrome (pBMES) is a painful condition of unknown cause. The term edema refers to the magnetic resonance imaging (MRI) findings of increased interstitial fluid in the bone marrow. While bone marrow edema in it self is a common MRI finding in various conditions such as trauma, infection, joint inflammation, and tumors—what distinguishes pBMES from these other conditions is its spontaneous onset, unknown cause, and self-limiting disease course. Current knowledge about pBMES is very limited, primarily based on reports of single cases or small series, which mainly involve adult males and pregnant females. The present project is an observational study with three primary aims: a) to determine the prognosis of pBMES in terms of pain and physical functioning; b) to assess the extent of bone marrow edema over time through repeated MRIs; and c) to evaluate the incidence of BMES using the population of Østfold County and the Vestby municipality in Norway as the denominator

Protocol for a scoping review on transient osteoporosis, bone marrow edema syndrome and related conditions

Proper classification plays an important role in defining the diagnosis, mechanisms and treatment of diseases. Logical discussion requires that patients with the same disease receive the same label. This issue is relevant for closely related disease concepts called transient osteoporosis of the hip (TOH), regional migratory osteoporosis (RMO), bone marrow edema syndrome (BMES) or localized osteoporosis (LO). Many other terms have also been used, see below. Patients who receive any of these diagnoses appear to have spontaneous joint pain, commonly in the lower limbs such as the hip or knee, and varying degree of local bone demineralization and/or bone marrow edema on magnetic resonance imaging (MRI). Spontaneous recovery seems to be common. Very little is known about epidemiology, etiology or pathophysiology. It has been questioned whether all the designations and labels really represent discrete disease entities, or are manifestations of a common, underlying pathology [1-6]. These conditions are rare, and the literature consists of scattered reports of single cases and small case series published over the last 60 years. The existing literature has, however, not been systematically reviewed or synthesized. Spurious labelling and inconsistent terminology hinder effective research and communication. Currently this field is confusing for clinicians, researchers, patients and the public. The aims of this scoping review are to (i) assess whether the designated terms (TOH, RMO, BMES and LO) clinically meaningful, and (ii) suggest changes if necessary