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Objective: A complex examination of patients with chronic myofascial pain syndrome (MPS)., Material and Methods: This study included 136 patients with MPS (66 men and 70 women). Pain was assessed using a Visual Analogue Scale (VAS). Investigation of profiles of natural antibodies (nAbs) to specific opioid peptides (β-endorphin and orphanin), biogenic amines (dopamine and serotonin), surface electromyography (SEMG) of m. errector spinae at the L3-L4 level bilaterally were performed. Measurements were done at 1st, 10th and 21st days of treatment., Results: There was a significant decrease in pain intensity (by 71% in men and by 63% in women) accompanied by a decrease in muscle tension by 10-25% in group values of SEMG amplitudes, and by 34-38% as assessed by individual dynamics of SEMG amplitudes. All nAbs levels were elevated or high in the 1st day. The dynamics of nAbs levels was multidirectional. At the 21st day, there was the increase in the incidence of patients with high nAbs levels to opioid peptides (39-41% women and 33-39% men) and patients with normal nAbs levels to serotonin (59% men and 52% women), while the levels of nAbs to dopamine decreased to normal levels in women (56%) and remained elevated (50%) or highly elevated (17%) in men., Conclusion: The dynamics of immune indicators correlates with pain intensity that possibly reflects the pathological changes in neural/humoral interactions in chronic pain. In this regard, monitoring of nAbs levels is prognostically relevant for assessment of risk of pain chronification.

Aim: To compare immunochemical and clinical parameters in patients with chronic radicular and myofascial back pain., Material and Methods: A study included 92 patients (55 men and 37 women) with radicular pain syndrome and 97 patients (33 men and 64 women) with myofascial pain syndrome. Pain status was assessed with the differential visual analogous scale (at rest, on movement, at night and during spontaneous pain). Tensor algometry was used to measure pain intolerance thresholds at day and night. Levels of natural antibodies (nAB) to endogenous pain regulators (β-endorphin, orphanin, serotonin, dopamine, histamine and angiotensin) were determined in the blood serum by ELISA. Patients were examined at admission to the hospital, on 10th and 21st days of treatment., Results and Conclusion: There was a significant decrease in pain syndrome in all patients to the 21st day. Pain intensity was higher in patients with radicular pain syndrome (р<0.05) in all functional states. Pain intolerance thresholds were initially reduced in both groups. No significant between-group differences in the dynamics were not found either in men or women. Women had lower pain intolerance thresholds compared to men. An analysis of nAB profiles to pain regulators showed that they were correlated with higher and high indices, with the predominance of nAB to β-endorphin, orphanin and histamine in both groups. The increased levels of antibodies circulate in the blood serum of patients with dorsalgia for a long time can further be a factor of pain chronification.

Objective: Our aim was to study the possible markers of pain syndrome--indicators of pain sensitivity--pain pressure tolerance thresholds (PPTT), and immuno-indicators--natural antibodies against pain processing mediators (eAb) for evaluation the possibility of its using for a objective pain assessment at chronic low back pain., Methods: Pain sensitivity was assessed daily and nightly, by measuring the PPTT The natural antibody levels (eAb), were determined in serum by ELISA. Measurement of all parameters were performed at 1st, 10th and 21 days., Results: 173 patients (93 women and 80 men) with chronic low back pain were included in the study. At 1st day most patients had lowered PPTT: 55% of men and 74% during the day, 72% of men and 89% of women at night. Dynamic study has shown a tendency of PPTT normalization in men. The study of diurnal PPTT variations have shown that night PPTT lower than day PPTT on 15-17%. We found gender PPTT differences: PPTT values in women 17-26% lower than in men. Analysis of individual eAb profiles has showed that elevated and high levels of eAb to β-endorphin, orphanin and histamine have 84%, 78%, 84% women and 82%, 85 and 95% men, respectively. These indicators higher than those for serotonin, dopamine and angiotensin (55%, 65%, 70% in women and 65%, 66%, 66% in men, respectively; p < 0.05). Dynamic study of eAb levels have shown a significant anti-histamine eAbs decrease (23%; p = 0.015) only., Conclusion: The pathological changes in pain sensitivity and levels of eAbs to pain-processing mediatos are evidenced. Further investigations are necessary to clarify to role of these variations in pain processing and for use these indicators for objective pain assessment.