The effects of running on systemic inflammatory markers in chronic low back pain: a secondary analysis of the ASTEROID randomised controlled trial

Musculoskelet Sci Pract. 2026 Mar 3;83:103539. doi: 10.1016/j.msksp.2026.103539. Online ahead of print.

ABSTRACT

BACKGROUND: Exercise is a well-established treatment for chronic low back pain (LBP), yet its effects on inflammation remain unclear.

OBJECTIVE: Examine the effects of running on inflammatory markers in chronic LBP and its associations with pain intensity, and mental health as an a priori secondary analysis.

METHODS: An a priori secondary analysis of a 12-week, two-arm, parallel-group randomised controlled trial was conducted. Forty adults with chronic LBP were randomised to a run-walk program or waitlist control. The intervention was a digitally delivered, remotely supervised run-walk program, prescribed three times per week for 30 min. Outcomes assessed included systemic inflammatory markers (C-reactive protein [CRP], interleukin-8 [IL-8], and tumour necrosis factor alpha [TNF-α] as well as pain intensity (Visual Analogue Scale), and mental health (21-item Depression, Anxiety, and Stress Scale).

RESULTS: No significant between-group differences were observed in CRP (ß [95% CI] = 0.34 [-0.07, 0.74] (log-transformed scale), p = 0.109), TNF-α (-1.29 [-6.15, 3.58] pg/mL, p = 0.595), or IL-8 (-0.36 [-1.30, 0.58] (log-transformed scale), p = 0.443) over the 12 weeks. The associations between changes in inflammatory markers and pain intensity or mental health were not different between groups (all p > 0.05).

CONCLUSIONS: A 12-week run-walk training did not alter systemic CRP, TNF-α, or IL-8 in adults with chronic LBP. Improvements in pain intensity were not associated with changes in these inflammatory markers. Clinically, this intervention offers a low-cost and accessible approach that provides meaningful improvements in chronic LBP without observed changes in systemic CRP, IL-8, and TNF-α.

PMID:41785570 | DOI:10.1016/j.msksp.2026.103539