Association of small nerve fiber dysfunction on pain characteristics in type 2 diabetes mellitus individuals with chronic low back pain
6 affiliations
- 1Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education
- 2Department of Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education
- 3Department of Radiodiagnosis and Imaging, Kasturba Medical College, Manipal Academy of Higher Education
- 4Department of Orthopaedics and Department of Podiatry, Karnataka Institute of Endocrinology and Research
- 5Department of Medicine, Kasturba Medical College, Manipal Academy of Higher Education
- 6Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education
Abstract
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.
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BibTeX
@article{jaya2026association,
title = {{Association of small nerve fiber dysfunction on pain characteristics in type 2 diabetes mellitus individuals with chronic low back pain}},
author = {Shetty Shrija Jaya and Shyamasunder Bhat N and Rajagopal Kadavigere and Pavan Belehalli and B. Ananthakrishna Shastry and Shreemathi S. Mayya and G. Arun Maiya},
journal = {Scientific Reports},
year = {2026},
month = aug,
doi = {10.1038/s41598-026-64722-2},
url = {https://doi.org/10.1038/s41598-026-64722-2},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association of small nerve fiber dysfunction on pain characteristics in type 2 diabetes mellitus individuals with chronic low back pain
AU - Shetty Shrija Jaya
AU - Shyamasunder Bhat N
AU - Rajagopal Kadavigere
AU - Pavan Belehalli
AU - B. Ananthakrishna Shastry
AU - Shreemathi S. Mayya
AU - G. Arun Maiya
PY - 2026
DA - 2026/08/01
JO - Scientific Reports
DO - 10.1038/s41598-026-64722-2
UR - https://doi.org/10.1038/s41598-026-64722-2
AB - 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.
SN - 2045-2322
ER -