title: Gender Influences Radicular Pain Perception in Patients with Lumbar Disc Herniation.
abstract: BACKGROUND
  Previous studies have demonstrated gender differences in pain perception in quantitative sensory testing. Thus, we hypothesized that there are differences in men and women with lumbar disc herniation awaiting lumbar sequestrectomy. To elucidate the differences in pain perception between men and women, we carried out a prospective clinical monocentric trial using quantitative sensory testing.
  
  
  METHODS
  With institutional ethical approval, patients with radiculopathy awaiting lumbar sequestrectomy were examined the day before surgery. Preoperative pain was assessed using quantitative sensory testing and a series of questionnaires including Beck Depression Inventory and a numeric rating scale (NRS) for back and leg pain. Statistical analysis was performed using the Kolmogorov-Smirnov test for normal distribution. The unpaired Student's t-test, Mann-Whitney U test, and Fisher's exact test were used to analyze intergroup differences in the clinical and demographic characteristics and in clinical outcome variables.
  
  
  RESULTS
  Fifty patients (20 women and 30 men) were included in the study. The groups did not differ in NRS for back and leg pain. Heat and pressure pain thresholds were found to be lower in women than in men (p≤0.05). Subgroup analyses revealed decreased wind-up ratio in male patients with prior periradicular steroid application (p≤0.05).
  
  
  CONCLUSIONS
  Our results clearly indicate that sex differences in pain perception not only exist in healthy subjects, but also in patients with lumbar disc herniation. Therefore, it is essential to provide different treatment modalities to women and men.
authors.affiliation: 1 Department of Neurosurgery, Medical University Innsbruck , Innsbruck, Austria .
authors.forename: Anja
authors.initials: A
authors.lastname: Tschugg
authors.affiliation: 2 Department of Neurology, Medical University Innsbruck , Innsbruck, Austria .
authors.forename: Wolfgang N
authors.initials: WN
authors.lastname: Löscher
authors.affiliation: 1 Department of Neurosurgery, Medical University Innsbruck , Innsbruck, Austria .
authors.forename: Sebastian
authors.initials: S
authors.lastname: Hartmann
authors.affiliation: 3 Department of Medical Statistics and Health Economics, Medical University Innsbruck , Innsbruck, Austria .
authors.forename: Sabrina
authors.initials: S
authors.lastname: Neururer
authors.affiliation: 4 Department of Neuroradiology, Medical University Innsbruck , Innsbruck, Austria .
authors.forename: Matthias
authors.initials: M
authors.lastname: Wildauer
authors.affiliation: 1 Department of Neurosurgery, Medical University Innsbruck , Innsbruck, Austria .
authors.forename: Claudius
authors.initials: C
authors.lastname: Thomé
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D006987:Hypesthesia / Q000503:physiopathology; D007405:Intervertebral Disc Displacement / Q000150:complications*; D008159:Lumbar Vertebrae / Q000294:innervation* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods*; D010146:Pain / Q000503:physiopathology; D058748:Pain Perception; D011446:Prospective Studies; D011843:Radiculopathy / Q000209:etiology / Q000503:physiopathology*; D012684:Sensory Thresholds / Q000502:physiology*; D012737:Sex Factors