Inflammatory biomarkers increase with severity of upper-extremity overuse disorders

Abstract

MSDs (musculoskeletal disorders) from overuse are common occupational health problems that cause pain, functional loss and loss of work time. The aim of the present study was to determine whether a relationship exists between the severity of early-onset overuse-related MSDs of the upper extremity and serum levels of IL-1beta (interleukin-1beta), TNF-alpha (tumour necrosis factor-alpha), IL-6 (interleukin-6) and CRP (C-reactive protein). Twenty-two subjects with upper-extremity MSDs due to overuse for no longer that 12 weeks were stratified according to the severity of upper-extremity signs and symptoms as determined by a UBMA (upper-body musculoskeletal assessment). Nine asymptomatic subjects also participated. Serum cytokines were analysed using ELISA, and CRP was analysed using a laser nephelometry technique. CRP was strongly correlated, and TNF-alpha, IL-1beta and IL-6 were moderately correlated, with UBMA scores. Only CRP and TNFalpha were significantly associated with UBMA scores in an ordinal logistic regression analysis in which age and BMI (body mass index) were covariates. These results are of clinical importance as they suggest that early-onset overuse-related MSDs may have an inflammatory component. The possibility of using a combination of serum biomarkers to follow the progression of overuse-related MSDs or their response to therapeutic intervention may be of interest to clinical practitioners and should be the focus of future research.

Serum and tissue cytokines and chemokines increase with repetitive upper extremity tasks

“…overuse injuries. 10 In contrast to our human study, we did not find increased serum IL-6 in this study, a result consistent with findings of a repetitive pinching task in a nonhuman primate model 6 and a study examining patients with carpal tunnel syndrome. 19 However, there was no detectable serum TNFa in those two studies 6,19 results differing from ours.…”

“…Although several studies have found increased serum biomarkers of injury, inflammation, or collagen turnover in patients with repetitive motion injury or following performance of repetitive tasks, 2,10,19,20 this is the first study to report the presence of chemokines in serum following performance of repetitive upper extremity tasks and to examine such a large panel of cytokines and chemokines in RMI. We have previously reported that performance of the HRNF task leads to increased serum IL-1a, results confirmed here.…”

“…2,3,[7][8][9] Increases in four circulating inflammatory mediators, C-reactive protein, interleukin 1 beta (IL-1b), IL-6, and tumor necrosis factor alpha (TNFa) have also been shown to increase in patients with upper extremity overuse disorders. 10 The factors triggering underlying pathophysiological responses are still under investigation, which impedes progress toward their primary and secondary prevention.Using a rat model, we have reported that repetitive reaching causes injury and wide-spread increases in macrophage influx into musculotendinous tissues and peripheral nerves, extraneural fibrosis, decreased nerve conduction, and decreased grip strength. [2][3][4]7,9 The macrophage response is associated with increased inflammatory cytokines in the median nerve, 9 and increased serum IL-1a following HRNF task performance.…”

“…2,3,[7][8][9] Increases in four circulating inflammatory mediators, C-reactive protein, interleukin 1 beta (IL-1b), IL-6, and tumor necrosis factor alpha (TNFa) have also been shown to increase in patients with upper extremity overuse disorders. 10 The factors triggering underlying pathophysiological responses are still under investigation, which impedes progress toward their primary and secondary prevention.…”

The rapid and progressive degeneration of the cervical multifidus in whiplash: A MRI study of fatty infiltration

“…37 Evidence from both an animal injury model 38 and human study of pulmonary dysfunction 39 indicates that higher levels of TNF-α may influence the recovery of muscle function. On the contrary, others have demonstrated increased levels of serum TNF-α in tandem with higher levels of disability in chronic low back pain, 40 upper extremity overuse injuries, 41 and significant losses of muscle mass in patients with cancer, AIDS and chronic obstructive pulmonary disease. 42 Further study investigating the directional influence of local inflammatory factors on muscle structure and function following whiplash is warranted and well underway.…”