C-reactive protein, chronic low back pain and, diet and lifestyle

Abstract C-reactive protein (CRP) is best known as an acute phase protein and is typically assessed in most general blood work. High sensitivity CRP (hsCRP) may be a useful clinical marker of chronic inflammatory states in musculoskeletal conditions. It appears that it is raised in inflammatory chronic low back pain (CLBP) and associated with reduced pain thresholds, weakness, and reduced function. It is also possible CRP could contribute towards the development and maintenance of CLBP by activating the complement system, which increases peripheral nociception. Diet and lifestyle factors can promote raised CRP. An hsCRP level of <1 mg/l appears ideal, and the higher the level, the more emphasis should be placed on chronic inflammation as a contributor to symptoms. Diet and lifestyle can significantly reduce CRP levels and may be a useful adjunct in treating CLBP patients with elevated CRP. This might make CRP a useful clinical marker of inflammation in CLBP and a therapeutic target for diet and lifestyle interventions.