Dietary Cholesterol is Associated with Increased Pain Sensitivity in Individuals with Chronic Low Back Pain

Chronic low back pain (cLBP) is one of the leading causes of pain and disability in adults in the United States. Given that approximately 90% of cLBP cases are of unknown pathogenic cause, it is imperative that other avenues to its onset be explored. Recently, it has been reported that diet quality can influence pain state via diet-induced inflammation and oxidative stress.The objective of this study was to assess the preliminary relationships between various nutrients and outcomes assessed in Quantitative Sensory Testing (QST) in individuals with cLBP. Eighty individuals with cLBP were recruited as a part of an on-going study. A diet recall was delivered to assess food intake 24 hours prior to pain testing and used to calculate a nutrient profile for each individual. Self-reported QST pain measures were obtained. Correlation analyses were used to examine the relationships between these variables. Significant positive correlations were found with multiple nutrients, but interestingly, dietary cholesterol in multiple QST modalities. Dietary cholesterol was significantly correlated with pain scores in cLBP participants during the cold pressor task (r=0.245, p=0.025), and pin prick temporal summation delta change scores at 256 nm size (r=0.235, p=0.030), and 512 nm size (r=0.272, p=0.012). Dietary cholesterol was significantly correlated with pain scores in cLBP participants in multiple modalities, indicating potential effects at multiple nociceptive fibers. It is possible that excess cholesterol peroxidation may be influencing inflammation and subsequent increases in pain sensitivity via oxidative stress in this population. Racial and Socioeconomic Differences in Chronic Low Back Pain