Evidence mapPaperPMID 42437260Full record

ReviewCureus2026

Autonomic Dysfunction as a Potential Pathophysiological Link Between Chronic Low Back Pain and Coronary Artery Disease: A Systematic Review.

Waqas Alauddin, Rahul Saxena, Arushi Saxena, Sayali Khairnar, Srisaisantoshini Sankaranarayanan, Brishabh R Prajesh, Fahad Shaikh, Soumya Singh

Abstract readReview
In one paragraph

Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Waqas AlauddinPhysiology, Dr. N. Y. Tasgaonkar Institute of Medical Science, Karjat, IND.
Rahul SaxenaPhysiology, Varun Arjun Medical College and Rohilkhand Hospital, Shahjahanpur, IND.
Arushi SaxenaAnesthesiology and Critical Care, Varun Arjun Medical College and Rohilkhand Hospital, Shahjahanpur, IND.
Sayali KhairnarMusculoskeletal Physiotherapy, Dr. N. Y. Tasgaonkar College of Physiotherapy, Karjat, IND.
Srisaisantoshini SankaranarayananCardiovascular and Pulmonary Physiotherapy, Dr. N. Y. Tasgaonkar College of Physiotherapy, Karjat, IND.
Brishabh R PrajeshMedicine, Naraina Medical College and Research Centre, Kanpur, IND.
Fahad ShaikhMedicine, N. K. P. Salve Institute of Medical Sciences and Research Centre, Nagpur, IND.
Soumya SinghOral Medicine and Radiology, Institute of Dental Studies and Technologies, Modinagar, IND.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic low back pain (CLBP) is a leading cause of disability worldwide and is increasingly recognized as a condition associated with systemic physiological alterations beyond musculoskeletal dysfunction. Emerging evidence suggests that autonomic nervous system dysregulation may be associated with impaired cardiovascular regulation and increased cardiovascular risk in individuals with CLBP. This systematic review aimed to evaluate the current evidence regarding autonomic dysfunction in CLBP and its potential association with cardiovascular disease. A comprehensive literature search was conducted according to the PRISMA 2020 guidelines across PubMed/MEDLINE, Scopus, Web of Science, EMBASE, CENTRAL, CINAHL, EBSCOhost, and Google Scholar from database inception through January 2026, along with gray literature sources. Studies evaluating autonomic or cardiovascular autonomic function in adults with CLBP were included. A total of 10 studies met the inclusion criteria. Most studies demonstrated reduced heart rate variability, diminished vagal activity, sympathetic predominance, impaired autonomic regulation, and delayed cardiovascular recovery in individuals with CLBP compared with healthy controls. Several studies also reported associations between autonomic dysfunction and pain-related disability, catastrophizing, kinesiophobia, and altered pain modulation. Population-based evidence suggested increased prevalence of coronary heart disease and myocardial infarction among individuals with CLBP, while interventional studies demonstrated improvements in autonomic regulation following yoga-based rehabilitation and spinal manipulative therapy. Overall, the certainty of evidence ranged from low to moderate because of methodological heterogeneity and the predominance of observational study designs. Current evidence suggests that CLBP is associated with clinically relevant autonomic and cardiovascular alterations. These findings highlight the importance of incorporating autonomic and cardiovascular assessment into multidisciplinary management strategies while emphasizing the need for further prospective and mechanistic research.

Indexed as

autonomic nervous system (ans)cardiovascular autonomic dysfunction (cad)chronic low back pain (clbp)coronary artery disease (cad)heart rate variability (hrv)risk factors of cardiovascular diseasessympathetic and parasympathetic activity

Identifiers

PMID42437260
PMCPMC13355550

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.