Inflammatory markers were most commonly measured followed by neurotransmitter-related genes and metabolite-detecting genes .
After exercise interventions , changes in biomarkers involved in neurotransmission and inflammation suggest a hypoalgesic exercise effect .
Significant biomarker associations were found with pain intensity , fatigue , depression , anxiety , and quality of life .
Discussion : It remains a question whether biomarkers can be used as objective measures for risk assessment , diagnosis , or evaluation or as surrogate endpoints in chronic pain .
Regardless , the potential translational value of biomarkers in chronic pain is evident .
Background : Chronic pain is highly prevalent .
Current management is challenged by lack of vali date d objective measures like biological markers .
Clinical pain studies employing exercise interventions have evaluated biomarkers ; however , it is unclear how exercise impacts biomarkers involved in pain pathways and whether these markers are associated with relevant pain-related outcomes .
This systematic review evaluates data from clinical studies employing exercise interventions in chronic musculoskeletal nonmalignant pain conditions in which biomarkers in pain pathways were measured .
Randomized Clinical Trial of Lumbar Instrumented Fusion and Cognitive Intervention and Exercises in Patients with Chronic Low Back Pain and Disc Degeneration
Study Design . Single blind r and omized study . Objectives . To compare the effectiveness of  lumbar instrumented fusion with cognitive intervention and exercises in patients with chronic low back pain and disc degeneration . Summary of Background Data . To the authors ’ best knowledge , only one r and omized study has evaluated the effectiveness of lumbar fusion . The Swedish Lumbar Spine Study reported that lumbar fusion was better than continuing physiotherapy and care by the family physician . Patients and Methods . Sixty-four patients aged 25–60 years with low back pain lasting longer than 1 year and evidence of disc degeneration at L4–L5 and /or L5–S1 at radiographic examination were r and omized to either lumbar fusion with posterior transpedicular screws and postoperative physiotherapy , or cognitive intervention and exercises . The cognitive intervention consisted of a lecture to give the patient an underst and ing that ordinary physical activity would not harm the disc and a recommendation to use the back and bend it . This was reinforced by three daily physical exercise sessions for 3 weeks . The main outcome measure was the Oswestry Disability Index . Results . At the 1-year follow-up visit , 97 % of the patients , including 6 patients who had either not attended treatment or changed groups , were examined . The Oswestry Disability Index was significantly reduced from 41 to 26 after surgery , compared with 42 to 30 after cognitive intervention and exercises . The mean difference between groups was 2.3 ( −6.7 to 11.4 ) ( P = 0.33 ) . Improvements inback pain , use of analgesics , emotional distress , life satisfaction , and return to work were not different . Fear-avoidance beliefs and fingertip-floor distance were reduced more after nonoperative treatment , and lower limb pain was reduced more after surgery . The success rateaccording to an independent observer was 70 % after surgery and 76 % after cognitive intervention and exercises .  The early complication rate in the surgical group was 18 % . Conclusion . The main outcome measure showed equal improvement in patients with chronic low back pain and disc degeneration r and omized to cognitive intervention and exercises , or lumbar fusion
Inflammatory markers were most commonly measured followed by neurotransmitter-related genes and metabolite-detecting genes .
After exercise interventions , changes in biomarkers involved in neurotransmission and inflammation suggest a hypoalgesic exercise effect .
Significant biomarker associations were found with pain intensity , fatigue , depression , anxiety , and quality of life .
Discussion : It remains a question whether biomarkers can be used as objective measures for risk assessment , diagnosis , or evaluation or as surrogate endpoints in chronic pain .
Regardless , the potential translational value of biomarkers in chronic pain is evident .
Background : Chronic pain is highly prevalent .
Current management is challenged by lack of vali date d objective measures like biological markers .
Clinical pain studies employing exercise interventions have evaluated biomarkers ; however , it is unclear how exercise impacts biomarkers involved in pain pathways and whether these markers are associated with relevant pain-related outcomes .
This systematic review evaluates data from clinical studies employing exercise interventions in chronic musculoskeletal nonmalignant pain conditions in which biomarkers in pain pathways were measured .