Differences in human assumed central sensitization between patients with radiating and non-radiating chronic low back pain: a cross-sectional observational study with special attention to sex

Radiating chronic low back pain (CLBP-r) is linked to more pain, more disability, and a lower quality of life than non-radiating chronic low back pain (CLBP-nr). Female patients experience higher pain intensity and greater incidence of pain-related conditions compared to males. The objectives are to compare clinical manifestations potentially associated with human assumed central sensitization (HACS) between: (1) patients with CLBP-r and CLBP-nr and (2) female and male patients. In this cross-sectional observational study, 142 patients with CLBP underwent quantitative sensory testing (QST), including mechanical detection thresholds, mechanical pain thresholds, pressure pain thresholds, wind-up ratio, conditioned pain modulation, and the central sensitization inventory (CSI) to assess HACS. Patients with CLBP-r based on radiculopathy, radicular pain, or segmental pain showed a higher mechanical detection threshold (8.0 [2.0–16.0] vs. 4.0 [1.0–8.0]; p p = 0.001) and lower CSI score (34.2 ± 13.7 vs. 40.6 ± 12.4; p = 0.005) compared to patients with CLBP-nr. Female patients showed lower mechanical pain threshold (32.0 [8.0–64.0]) vs. (96.0 [32.0–128.0]; p p Radiating pain and sex appears to influence clinical expressions attributed to HACS. Patients with CLBP-r showed higher mechanical thresholds and female patients presented lower mechanical and pressure pain thresholds. Interpretation should consider the cross-sectional design, the use of two data sets and unresolved clinical relevance. https://trialsearch.who.int/ identifiers are NL-OMON24108 and NL-OMON24502. People with chronic low back pain can have pain that stays in the lower back (non-radiating) or pain that spreads to the legs (radiating). Radiating pain is often linked to more pain, more disability, and a lower quality of life. Women usually report stronger pain and more pain-related problems than men. This study looked at whether these differences are related to something called central sensitization, which means the nervous system becomes more sensitive to pain. We studied 142 people with chronic low back pain and tested how sensitive they were to touch and pressure. We measured things like how easily they feel touch, how easily touch feels painful, and how much pressure causes pain. We also used a questionnaire to check symptoms of sensitization. The results showed that people with radiating pain needed stronger touch and pressure to feel pain, and they had lower scores on the sensitization questionnaire compared to people with non-radiating pain. Women were more sensitive to pain than men, they felt pain with lighter touch and lighter pressure. These findings suggest that both the type of pain and sex affect pain sensitivity. However, this study only looked at one point in time, used two data sets, and we still do not know how important these differences are for treatment. More research is needed to understand what this means for individual patients and how it can help improve care.