Autonomic Dysfunction as a Potential Pathophysiological Link Between Chronic Low Back Pain and Coronary Artery...

Area of Science:

• Cardiology
• Neurology
• Pain Medicine

Background:

• Chronic low back pain (CLBP) is a global health concern, often extending beyond musculoskeletal issues.
• Emerging research links CLBP to autonomic nervous system (ANS) dysregulation, potentially increasing cardiovascular risk.

Purpose of the Study:

• To systematically review evidence on autonomic dysfunction in CLBP patients.
• To explore the association between autonomic dysfunction and cardiovascular disease in CLBP.

Main Methods:

• A comprehensive systematic literature search was performed across major databases (PubMed, Scopus, Web of Science, etc.) adhering to PRISMA 2020 guidelines.
• Included studies evaluated autonomic or cardiovascular autonomic function in adults diagnosed with CLBP.
• Ten studies met the inclusion criteria for this review.

Main Results:

• Most studies indicated reduced heart rate variability, diminished vagal activity, and sympathetic predominance in CLBP individuals compared to controls.
• Autonomic dysfunction was associated with increased pain-related disability, catastrophizing, and kinesiophobia.
• Evidence suggests a higher prevalence of coronary heart disease and myocardial infarction in CLBP populations, with some interventions improving autonomic regulation.

Conclusions:

• CLBP is associated with significant autonomic and cardiovascular alterations.
• Findings underscore the importance of assessing autonomic and cardiovascular function in CLBP management.
• Further prospective and mechanistic research is crucial to confirm these associations and guide interventions.