Key result
Chronic low back pain in adults was associated with higher sympathetic activity (SD2, SS, S:PS ratio: p<0.001) and lower parasympathetic activity (rMSSD: p<0.001) compared to healthy subjects.
Why the study?
Chronic pain is a leading cause of disability worldwide and has been associated with a potential impact on autonomic balance.
Does chronic low back pain alter autonomic balance as measured by heart rate variability in adults?
Observational
Does chronic low back pain alter autonomic balance as measured by heart rate variability in adults?
p-value: p=<0.001
Chronic low back pain is associated with an autonomic imbalance characterized by increased sympathetic and decreased parasympathetic activity.
May link chronic low back pain to autonomic imbalance; observational data leave open causality and clinical relevance.
Background: Chronic pain has been reported as one of the leading causes of disability in the world, being associated with a potential impact on autonomic balance. Objective: The aim was to compare sympathetic and parasympathetic activity through heart rate variability (HRV) between adults with and without chronic low back pain (CLBP). Methods: An observational study was conducted in which HRV parameters were recorded using time-domain measures—root mean square of successive differences between consecutive RR intervals (rMSSD), minimum and maximum heart rate variability (Min HR and Max HR), and mean heart rate (Mean HR)—and nonlinear measures—Poincaré plot indices SD1 and SD2, Stress Score (SS), and sympathetic/parasympathetic ratio (S:PS). Results: The results showed statistically significant differences between groups (p < 0.05), with higher parasympathetic activity parameters in the group of healthy subjects (rMSSD: p < 0.001; SD1: p = 0.030) and higher sympathetic activity in the CLBP group (SD2, SS, and S:PS ratio: p < 0.001). All parameters showed large effect sizes. Conclusions: These findings show the association between autonomic balance mechanisms and pain regulation in adults with CLBP.
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Fernández‐Morales et al. (2025) conducted an observational in Chronic low back pain. Chronic low back pain vs. Without chronic low back pain (healthy subjects) was evaluated on Heart rate variability parameters (rMSSD, SD1, SD2, SS, S:PS ratio) (p=<0.001). Chronic low back pain in adults was associated with higher sympathetic activity (SD2, SS, S:PS ratio: p<0.001) and lower parasympathetic activity (rMSSD: p<0.001) compared to healthy subjects.
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