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<p>Type 2 diabetes mellitus (T2DM) is associated with small nerve fiber (SNF) dysfunction. Quantitative assessment of thermal perception thresholds is a validated method for evaluating SNF dysfunction. Pain characteristics such as numbness and pain irritability are commonly reported in T2DM individuals with chronic low back pain (CLBP). This study aimed to evaluate SNF dysfunction and its association with pain characteristics among T2DM individuals with CLBP. Fifty T2DM participants with CLBP underwent assessment of SNF function using a Sensitometer thermal perception device. Warm detection threshold, heat pain threshold, cold detection threshold, and cold pain threshold were measured over the lumbar region. Pain characteristics like pain irritability and numbness were recorded. One-sample Wilcoxon signed-rank test was used to compare thermal perception thresholds with published reference values. Kruskal–Wallis was used to examine their association with pain characteristics. Compared with reference values, participants demonstrated significantly higher heat pain thresholds (median 46.35&#xa0;°C [IQR 1.82] vs. 43.5&#xa0;°C, <i>p</i> &lt; 0.001), lower cold detection thresholds (28.15&#xa0;°C [IQR 2.87] vs. 29.5&#xa0;°C, <i>p</i> &lt; 0.001), and lower cold pain thresholds (2.25&#xa0;°C [IQR 15.82] vs. 26&#xa0;°C, <i>p</i> &lt; 0.001). Higher heat pain thresholds were significantly associated with greater pain irritability (<i>p</i> &lt; 0.001). These findings indicate altered thermal perception suggestive of SNF dysfunction among T2DM individuals with CLBP, with greater thermal abnormalities associated with increased pain irritability.</p>

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Association of small nerve fiber dysfunction on pain characteristics in type 2 diabetes mellitus individuals with chronic low back pain

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月4日

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  • Shetty Shrija Jaya,
  • Shyamasunder Bhat N,
  • Rajagopal Kadavigere,
  • Pavan Belehalli,
  • B. Ananthakrishna Shastry,
  • Shreemathi S. Mayya,
  • G. Arun Maiya

摘要

Type 2 diabetes mellitus (T2DM) is associated with small nerve fiber (SNF) dysfunction. Quantitative assessment of thermal perception thresholds is a validated method for evaluating SNF dysfunction. Pain characteristics such as numbness and pain irritability are commonly reported in T2DM individuals with chronic low back pain (CLBP). This study aimed to evaluate SNF dysfunction and its association with pain characteristics among T2DM individuals with CLBP. Fifty T2DM participants with CLBP underwent assessment of SNF function using a Sensitometer thermal perception device. Warm detection threshold, heat pain threshold, cold detection threshold, and cold pain threshold were measured over the lumbar region. Pain characteristics like pain irritability and numbness were recorded. One-sample Wilcoxon signed-rank test was used to compare thermal perception thresholds with published reference values. Kruskal–Wallis was used to examine their association with pain characteristics. Compared with reference values, participants demonstrated significantly higher heat pain thresholds (median 46.35 °C [IQR 1.82] vs. 43.5 °C, p < 0.001), lower cold detection thresholds (28.15 °C [IQR 2.87] vs. 29.5 °C, p < 0.001), and lower cold pain thresholds (2.25 °C [IQR 15.82] vs. 26 °C, p < 0.001). Higher heat pain thresholds were significantly associated with greater pain irritability (p < 0.001). These findings indicate altered thermal perception suggestive of SNF dysfunction among T2DM individuals with CLBP, with greater thermal abnormalities associated with increased pain irritability.