{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T18:33:56Z","timestamp":1793126036029,"version":"4.5.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"The Region of Southern Denmark"},{"name":"The Danish Rheumatism Foundation"},{"name":"The Danish Foundation for Chiropractic Research and Post Graduate Education"},{"name":"L. and H. Hansen\u2019s Foundation"},{"name":"L. F. Foght\u2019s Foundation"},{"name":"A. Muusfeldt\u2019s Foundation"},{"DOI":"10.13039\/501100023490","name":"The IMK Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100023490","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    A frequent cause of acute low back pain with radiating leg pain is lumbar disc herniation. In a clinical context, it can be very difficult to know which segment, let alone which anatomical structure, is responsible for the nociception that patients perceive as low back pain. Quantitative sensory pain testing (QST) is a method that quantifies the pain response. The aim of this study was to investigate whether the level of disc herniation correlates with mechanical and\/or thermal pain thresholds in patients with lumbar disc herniation, with the lowest pain thresholds being at the affected level. A cross-sectional study with 102 participants with lumbar disc herniation verified by MRI was conducted. Participants were tested at baseline with an algometer measuring pressure pain threshold (PPT) and a thermode measuring heat pain threshold (HPT). Measurements were collected at five sites, 2\u00a0cm lateral to the L1 to L5 processus spinosi. The data showed a significant association between the proximity to the level of disc herniation to the QST test site and the mechanical PPT thresholds with the lowest pain thresholds closest to the level of disc herniation (slope, 6.1; 95%CI 1.79 to 10.4;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.005). There was no association for HPTs. Pain thresholds were associated with the level of disc herniation when measured with mechanical pressure but not with heat.\n                  <\/jats:p>","DOI":"10.1038\/s41598-025-24918-4","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T16:06:34Z","timestamp":1764345994000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association between pain sensitivity and distance from the affected level of disc herniation"],"prefix":"10.1038","volume":"15","author":[{"given":"Johanne Brinch","family":"Filtenborg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Haig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berit","family":"Schi\u00f8ttz-Christensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirstine","family":"Amris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles Ludger","family":"Fournier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rune Mygind","family":"Mieritz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorthe Sch\u00f8ler","family":"Ziegler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren","family":"O\u2019Neill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"24918_CR1","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1016\/j.amjmed.2023.03.024","volume":"136","author":"AS Zhang","year":"2023","unstructured":"Zhang, A. S. et al. Lumbar disc herniation: diagnosis and management. Am. J. Med. 136, 645\u2013651 (2023).","journal-title":"Am. J. Med."},{"key":"24918_CR2","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1016\/j.spinee.2013.08.003","volume":"14","author":"DS Kreiner","year":"2014","unstructured":"Kreiner, D. S. et al. An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy. Spine J. 14, 180\u2013191 (2014).","journal-title":"Spine J."},{"key":"24918_CR3","doi-asserted-by":"crossref","unstructured":"Van Der Windt, D. A. et al. Physical examination for lumbar radiculopathy due to disc herniation in patients with low-back pain. The Cochrane Library, 2 (2010).","DOI":"10.1002\/14651858.CD007431.pub2"},{"key":"24918_CR4","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.1097\/BRS.0000000000002102","volume":"42","author":"MJ Hancock","year":"2017","unstructured":"Hancock, M. J., Kjaer, P., Kent, P., Jensen, R. K. & Jensen, T. S. Is the number of different MRI findings more strongly associated with low back pain than single MRI findings? Spine 42, 1283\u20131288 (2017).","journal-title":"Spine"},{"key":"24918_CR5","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s12998-018-0207-x","volume":"26","author":"JH Kim","year":"2018","unstructured":"Kim, J. H. et al. Diagnostic accuracy of diagnostic imaging for lumbar disc herniation in adults with low back pain or sciatica is unknown; a systematic review. Chiropr. Man. Ther. 26, 37 (2018).","journal-title":"Chiropr. Man. Ther."},{"key":"24918_CR6","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.1097\/01.brs.0000162396.97739.76","volume":"30","author":"P Kjaer","year":"2005","unstructured":"Kjaer, P., Leboeuf-Yde, C., Korsholm, L., Sorensen, J. S. & Bendix, T. Magnetic resonance imaging and low back pain in adults: A diagnostic imaging study of 40-year-old men and women. Spine 30, 1173\u20131180 (2005).","journal-title":"Spine"},{"key":"24918_CR7","doi-asserted-by":"publisher","first-page":"403","DOI":"10.2106\/00004623-199072030-00013","volume":"72","author":"SD Boden","year":"1990","unstructured":"Boden, S. D., Davis, D., Dina, T., Patronas, N. & Wiesel, S. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J. Bone Joint Surg. Am. 72, 403\u2013408 (1990).","journal-title":"J. Bone Joint Surg. Am."},{"key":"24918_CR8","doi-asserted-by":"publisher","first-page":"811","DOI":"10.3174\/ajnr.A4173","volume":"36","author":"W Brinjikji","year":"2015","unstructured":"Brinjikji, W. et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am. J. Neuroradiol. 36, 811\u2013816 (2015).","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"24918_CR9","doi-asserted-by":"publisher","first-page":"e107","DOI":"10.1179\/106698109791352201","volume":"17","author":"PA Anloague","year":"2009","unstructured":"Anloague, P. A. & Huijbregts, P. Anatomical variations of the lumbar plexus: A descriptive anatomy study with proposed clinical implications. J. Man. Manip. Ther. 17, e107\u2013e114 (2009).","journal-title":"J. Man. Manip. Ther."},{"key":"24918_CR10","doi-asserted-by":"publisher","first-page":"171","DOI":"10.36076\/ppj.2012\/15\/171","volume":"2;15","author":"MJ DePalma","year":"2012","unstructured":"DePalma, M. J. Multivariable analysis of the relationship between pain referral patterns and the source of chronic low back pain. Pain Physician. 2;15, 171\u2013178 (2012).","journal-title":"Pain Physician"},{"key":"24918_CR11","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1038\/nrrheum.2010.107","volume":"6","author":"T Graven-Nielsen","year":"2010","unstructured":"Graven-Nielsen, T. & Arendt-Nielsen, L. Assessment of mechanisms in localized and widespread musculoskeletal pain. Nat. Rev. Rheumatol. 6, 599\u2013606 (2010).","journal-title":"Nat. Rev. Rheumatol."},{"key":"24918_CR12","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1002\/ejp.2119","volume":"27","author":"M Curatolo","year":"2023","unstructured":"Curatolo, M. Personalized medicine: somatosensory phenotyping in musculoskeletal pain conditions. Eur. J. Pain. 27, 1099\u20131106 (2023).","journal-title":"Eur. J. Pain"},{"key":"24918_CR13","doi-asserted-by":"publisher","first-page":"698","DOI":"10.2519\/jospt.2019.8876","volume":"49","author":"HL Bandt","year":"2019","unstructured":"Bandt, H. L. et al. Pain mechanisms in low back pain: A systematic review with Meta-analysis of mechanical quantitative sensory testing outcomes in people with nonspecific low back pain. J. Orthop. Sports Phys. Ther. 49, 698\u2013715 (2019).","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"24918_CR14","doi-asserted-by":"crossref","unstructured":"Harris, P. et al. The REDCap consortium: Building an international community of software partners. REDCap Consortium REDCap Consortium: Building Int. Community Softw. Partners J. Biomed. Inform May 9, 130208. (2019).","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"24918_CR15","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","volume":"42","author":"PA Harris","year":"2009","unstructured":"Harris, P. A. et al. Research electronic data capture (REDCap) - A metadata-driven methodology and workflow process for providing translational research informatics support. J. Biomed. Inform. 42, 377\u2013381 (2009).","journal-title":"J. Biomed. Inform."},{"key":"24918_CR16","doi-asserted-by":"crossref","unstructured":"Dworkin, R. H. et al. Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain 113 (1), 9\u201319 (2005).","DOI":"10.1016\/j.pain.2004.09.012"},{"key":"24918_CR17","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1515\/sjpain-2019-0082","volume":"20","author":"S O\u2019Neill","year":"2020","unstructured":"O\u2019Neill, S., Jensen, T. S. & Kent, P. Computerized quantification of pain drawings. Scandinavian J. Pain. 20, 175\u2013189 (2020).","journal-title":"Scandinavian J. Pain"},{"key":"24918_CR18","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.pain.2006.01.041","volume":"123","author":"R Rolke","year":"2006","unstructured":"Rolke, R. et al. Quantitative sensory testing in the German research network on neuropathic pain (DFNS): standardized protocol and reference values. Pain 123, 231\u2013243 (2006).","journal-title":"Pain"},{"key":"24918_CR19","unstructured":"Magee, J. & Spine, D. L. Orthopedic Physical Assessment. ED 5, St. Louis: Saunders Elsevier, 585\u2013588. (2008)."},{"key":"24918_CR20","doi-asserted-by":"crossref","unstructured":"Bates, D., M\u00e4chler, M., Bolker, B. & Walker, S. Fitting linear Mixed-Effects models using {lme4}. Journal Stat. Software. 67 (1), (2015).","DOI":"10.18637\/jss.v067.i01"},{"key":"24918_CR21","unstructured":"Lenth, R. V. & Emmeans Estimated Marginal Means, aka Least-Squares Means. (2024)."},{"key":"24918_CR22","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1113\/jphysiol.1992.sp019068","volume":"448","author":"RH LaMotte","year":"1992","unstructured":"LaMotte, R. H., Lundberg, L. E. & Torebj\u00f6rk, H. E. Pain, hyperalgesia and activity in nociceptive C units in humans after intradermal injection of capsaicin. J. Physiol. 448, 749 (1992).","journal-title":"J. Physiol."},{"key":"24918_CR23","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1016\/j.jpain.2009.02.002","volume":"10","author":"L Arendt-Nielsen","year":"2009","unstructured":"Arendt-Nielsen, L. & Yarnitsky, D. Experimental and clinical applications of quantitative sensory testing applied to Skin, muscles and viscera. J. Pain. 10, 556\u2013572 (2009).","journal-title":"J. Pain"},{"key":"24918_CR24","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1016\/j.jpain.2011.04.001","volume":"12","author":"B Ruiz-Ruiz","year":"2011","unstructured":"Ruiz-Ruiz, B., Fern\u00e1ndez-de-las-Pe\u00f1as, C., Ortega-Santiago, R., Arendt-Nielsen, L. & Madeleine, P. Topographical pressure and thermal pain sensitivity mapping in patients with unilateral lateral epicondylalgia. J. Pain. 12, 1040\u20131048 (2011).","journal-title":"J. Pain"},{"key":"24918_CR25","doi-asserted-by":"publisher","first-page":"1146","DOI":"10.1016\/j.pain.2011.01.047","volume":"152","author":"AY Neziri","year":"2011","unstructured":"Neziri, A. Y. et al. Factor analysis of responses to thermal, electrical, and mechanical painful stimuli supports the importance of multi-modal pain assessment. Pain 152, 1146\u20131155 (2011).","journal-title":"Pain"},{"key":"24918_CR26","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1515\/sjpain-2018-0113","volume":"19","author":"S O\u2019Neill","year":"2019","unstructured":"O\u2019Neill, S., Larsen, J. B., Nim, C. & Arendt-Nielsen, L. Topographic mapping of pain sensitivity of the lower back \u2013 a comparison of healthy controls and patients with chronic non-specific low back pain. Scandinavian J. Pain. 19, 25\u201337 (2019).","journal-title":"Scandinavian J. Pain"},{"key":"24918_CR27","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s12998-022-00436-2","volume":"30","author":"CG Nim","year":"2022","unstructured":"Nim, C. G., Aspinall, S. L., Weibel, R., Steenfelt, M. G. & O\u2019Neill, S. Pressure pain thresholds in a real-world chiropractic setting: Topography, changes after treatment, and clinical relevance? Chiropr. Man. Ther. 30, 25 (2022).","journal-title":"Chiropr. Man. Ther."},{"key":"24918_CR28","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1054\/math.2000.0377","volume":"6","author":"L Keating","year":"2001","unstructured":"Keating, L. et al. Mid-thoracic tenderness: A comparison of pressure pain threshold between spinal regions, in asymptomatic subjects. Man. Therap. 6, 34\u201339 (2001).","journal-title":"Man. Therap."},{"key":"24918_CR29","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1186\/1471-2474-11-234","volume":"11","author":"AT Binderup","year":"2010","unstructured":"Binderup, A. T., Arendt-Nielsen, L. & Madeleine, P. Pressure pain sensitivity maps of the neck-shoulder and the low back regions in men and women. BMC Musculoskelet. Disord. 11, 234 (2010).","journal-title":"BMC Musculoskelet. Disord."},{"key":"24918_CR30","doi-asserted-by":"publisher","first-page":"644","DOI":"10.2519\/jospt.2011.3666","volume":"41","author":"DM Walton","year":"2011","unstructured":"Walton, D. M. et al. Reliability, standard error, and minimum detectable change of clinical pressure pain threshold testing in people with and without acute neck pain. J. Orthop. Sports Phys. Ther. 41, 644\u2013650. https:\/\/doi.org\/10.2519\/jospt.2011.3666 (2011).","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"24918_CR31","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1177\/20494637221147185","volume":"17","author":"RG Koh","year":"2023","unstructured":"Koh, R. G. et al. Reliability and minimal detectable difference of pressure pain thresholds in a pain-free population. Br. J. Pain. 17, 239\u2013243. https:\/\/doi.org\/10.1177\/20494637221147185 (2023).","journal-title":"Br. J. Pain"},{"key":"24918_CR32","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1080\/003655098444255","volume":"30","author":"F Antonaci","year":"1998","unstructured":"Antonaci, F., Sand, T. & Lucas, G. A. Pressure algometry in healthy subjects: Inter-examiner variability. Scand. J. Rehabil. Med. 30, 3\u20138. https:\/\/doi.org\/10.1080\/003655098444255 (1998).","journal-title":"Scand. J. Rehabil. Med."},{"key":"24918_CR33","doi-asserted-by":"publisher","first-page":"e0233521","DOI":"10.1371\/journal.pone.0233521","volume":"15","author":"N Middlebrook","year":"2020","unstructured":"Middlebrook, N. et al. Reliability of Temporal summation, thermal and pressure pain thresholds in a healthy cohort and musculoskeletal trauma population. PLoS ONE. 15, e0233521. https:\/\/doi.org\/10.1371\/journal.pone.0233521 (2020).","journal-title":"PLoS ONE"},{"key":"24918_CR34","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1016\/j.jpain.2015.01.476","volume":"16","author":"S O\u2019Neill","year":"2015","unstructured":"O\u2019Neill, S. & O\u2019Neill, L. Improving QST Reliability\u2013More Raters, Tests, or occasions? A multivariate generalizability study. J. Pain. 16, 454\u2013462. https:\/\/doi.org\/10.1016\/j.jpain.2015.01.476 (2015).","journal-title":"J. Pain"},{"key":"24918_CR35","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1097\/AJP.0000000000000499","volume":"34","author":"W Adamczyk","year":"2018","unstructured":"Adamczyk, W., Luedtke, K. & Saulicz, E. Lumbar tactile acuity in patients with low back pain and healthy controls: systematic review and Meta-Analysis. Clin. J. Pain. 34, 82. https:\/\/doi.org\/10.1097\/AJP.0000000000000499 (2018).","journal-title":"Clin. J. Pain"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-24918-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-24918-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-24918-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T14:29:42Z","timestamp":1764599382000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-24918-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,28]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["24918"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-24918-4","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,28]]},"assertion":[{"value":"5 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"42893"}}