心理社会因素与硬膜外类固醇注射治疗慢性腰骶神经根性疼痛反应的关系:一项前瞻性先导研究。

IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY
Journal of Pain Research Pub Date : 2025-04-11 eCollection Date: 2025-01-01 DOI:10.2147/JPR.S496290
Meredith Stensland, Elizabeth Sanford, Timothy T Houle, Cindy McGeary, Briana A Cobos, Selena Lugosi, Luke Lehman, Paul S Nabity, Caleigh Covell, Elizabeth Fitzgerald, Mahsa Mojallal, David E Reed, Sanjog Pangarkar, Blessen C Eapen, Udai Nanda, Zachary L McCormick, Donald McGeary
{"title":"心理社会因素与硬膜外类固醇注射治疗慢性腰骶神经根性疼痛反应的关系:一项前瞻性先导研究。","authors":"Meredith Stensland, Elizabeth Sanford, Timothy T Houle, Cindy McGeary, Briana A Cobos, Selena Lugosi, Luke Lehman, Paul S Nabity, Caleigh Covell, Elizabeth Fitzgerald, Mahsa Mojallal, David E Reed, Sanjog Pangarkar, Blessen C Eapen, Udai Nanda, Zachary L McCormick, Donald McGeary","doi":"10.2147/JPR.S496290","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Chronic lumbosacral radicular pain is a disabling condition commonly treated with epidural steroid injections (ESIs). Extant research suggests that psychosocial factors impact clinical outcomes among patients with back pain. The purpose of this study is to examine the relationship between psychosocial variables and post-injection pain intensity.</p><p><strong>Setting: </strong>Interventional pain management clinic.</p><p><strong>Methods: </strong>A prospective longitudinal cohort study with repeated within-subject measures. Assessment timepoints included a pre-injection baseline, immediately post-injection, 6 weeks, and 12 weeks, and 6 months; patients completed a battery of self-report assessments at each point. The primary outcome was pain intensity (numeric rating scale 0-10). Data were analyzed using principal component analysis and generalized linear mixed-effects modeling.</p><p><strong>Results: </strong>A total of 40 patients (age 52 ±13.05) participated in this study. Higher pre-injection pain was predictive of higher post-injection pain at all time points (<i>p</i><0.001). Controlling for baseline pain and demographics, those with Negative Affect 1 standard deviation higher at baseline reported a 1.12-point mean higher pain rating at 12 weeks than those with lower Negative Affect (95% CI: 0.18-2.07; p=0.020), while those with <i>Cognitive Resilience</i> 1 standard deviation higher at baseline had a 1.12-point mean lower pain rating at 6 months post-injection (95% CI: -2.09 -0.05, p=0.040).</p><p><strong>Conclusion: </strong>Patients with higher negative affect and lower cognitive resilience achieve less pain improvement after ESIs for low back pain. Future research with a larger sample should focus on deepening our understanding of the role of psychosocial functioning as a potential mechanism of treatment response in patients undergoing ESI procedures. Findings point to the importance of multidisciplinary chronic pain care.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"1991-2002"},"PeriodicalIF":2.5000,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000912/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Relationship Between Psychosocial Factors and Response to Epidural Steroid Injection for Chronic Lumbosacral Radicular Pain: A Prospective Pilot Study.\",\"authors\":\"Meredith Stensland, Elizabeth Sanford, Timothy T Houle, Cindy McGeary, Briana A Cobos, Selena Lugosi, Luke Lehman, Paul S Nabity, Caleigh Covell, Elizabeth Fitzgerald, Mahsa Mojallal, David E Reed, Sanjog Pangarkar, Blessen C Eapen, Udai Nanda, Zachary L McCormick, Donald McGeary\",\"doi\":\"10.2147/JPR.S496290\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Chronic lumbosacral radicular pain is a disabling condition commonly treated with epidural steroid injections (ESIs). Extant research suggests that psychosocial factors impact clinical outcomes among patients with back pain. The purpose of this study is to examine the relationship between psychosocial variables and post-injection pain intensity.</p><p><strong>Setting: </strong>Interventional pain management clinic.</p><p><strong>Methods: </strong>A prospective longitudinal cohort study with repeated within-subject measures. Assessment timepoints included a pre-injection baseline, immediately post-injection, 6 weeks, and 12 weeks, and 6 months; patients completed a battery of self-report assessments at each point. The primary outcome was pain intensity (numeric rating scale 0-10). Data were analyzed using principal component analysis and generalized linear mixed-effects modeling.</p><p><strong>Results: </strong>A total of 40 patients (age 52 ±13.05) participated in this study. Higher pre-injection pain was predictive of higher post-injection pain at all time points (<i>p</i><0.001). Controlling for baseline pain and demographics, those with Negative Affect 1 standard deviation higher at baseline reported a 1.12-point mean higher pain rating at 12 weeks than those with lower Negative Affect (95% CI: 0.18-2.07; p=0.020), while those with <i>Cognitive Resilience</i> 1 standard deviation higher at baseline had a 1.12-point mean lower pain rating at 6 months post-injection (95% CI: -2.09 -0.05, p=0.040).</p><p><strong>Conclusion: </strong>Patients with higher negative affect and lower cognitive resilience achieve less pain improvement after ESIs for low back pain. Future research with a larger sample should focus on deepening our understanding of the role of psychosocial functioning as a potential mechanism of treatment response in patients undergoing ESI procedures. Findings point to the importance of multidisciplinary chronic pain care.</p>\",\"PeriodicalId\":16661,\"journal\":{\"name\":\"Journal of Pain Research\",\"volume\":\"18 \",\"pages\":\"1991-2002\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-04-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000912/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pain Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/JPR.S496290\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pain Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/JPR.S496290","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

摘要

目的:慢性腰骶神经根性疼痛是一种致残性疾病,通常采用硬膜外类固醇注射(ESIs)治疗。现有研究表明,心理社会因素影响背痛患者的临床结果。本研究的目的是检验社会心理变量与注射后疼痛强度之间的关系。地点:介入性疼痛管理诊所。方法:前瞻性纵向队列研究,重复受试者测量。评估时间点包括注射前基线、注射后立即基线、6周基线、12周基线和6个月基线;患者在每个点完成一系列自我报告评估。主要结局为疼痛强度(数值评分0-10)。数据分析采用主成分分析和广义线性混合效应模型。结果:共40例患者(年龄52±13.05)参与本研究。在所有时间点,较高的注射前疼痛预示着较高的注射后疼痛(pCognitive Resilience在基线时高1个标准差,在注射后6个月平均疼痛评分降低1.12点(95% CI: -2.09 -0.05, p=0.040)。结论:负性情绪高、认知恢复力低的腰痛患者,腰痛治疗后疼痛改善效果较差。未来更大样本的研究应侧重于加深我们对心理社会功能作为ESI患者治疗反应的潜在机制的作用的理解。研究结果指出多学科慢性疼痛护理的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Relationship Between Psychosocial Factors and Response to Epidural Steroid Injection for Chronic Lumbosacral Radicular Pain: A Prospective Pilot Study.

Purpose: Chronic lumbosacral radicular pain is a disabling condition commonly treated with epidural steroid injections (ESIs). Extant research suggests that psychosocial factors impact clinical outcomes among patients with back pain. The purpose of this study is to examine the relationship between psychosocial variables and post-injection pain intensity.

Setting: Interventional pain management clinic.

Methods: A prospective longitudinal cohort study with repeated within-subject measures. Assessment timepoints included a pre-injection baseline, immediately post-injection, 6 weeks, and 12 weeks, and 6 months; patients completed a battery of self-report assessments at each point. The primary outcome was pain intensity (numeric rating scale 0-10). Data were analyzed using principal component analysis and generalized linear mixed-effects modeling.

Results: A total of 40 patients (age 52 ±13.05) participated in this study. Higher pre-injection pain was predictive of higher post-injection pain at all time points (p<0.001). Controlling for baseline pain and demographics, those with Negative Affect 1 standard deviation higher at baseline reported a 1.12-point mean higher pain rating at 12 weeks than those with lower Negative Affect (95% CI: 0.18-2.07; p=0.020), while those with Cognitive Resilience 1 standard deviation higher at baseline had a 1.12-point mean lower pain rating at 6 months post-injection (95% CI: -2.09 -0.05, p=0.040).

Conclusion: Patients with higher negative affect and lower cognitive resilience achieve less pain improvement after ESIs for low back pain. Future research with a larger sample should focus on deepening our understanding of the role of psychosocial functioning as a potential mechanism of treatment response in patients undergoing ESI procedures. Findings point to the importance of multidisciplinary chronic pain care.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Journal of Pain Research
Journal of Pain Research CLINICAL NEUROLOGY-
CiteScore
4.50
自引率
3.70%
发文量
411
审稿时长
16 weeks
期刊介绍: Journal of Pain Research is an international, peer-reviewed, open access journal that welcomes laboratory and clinical findings in the fields of pain research and the prevention and management of pain. Original research, reviews, symposium reports, hypothesis formation and commentaries are all considered for publication. Additionally, the journal now welcomes the submission of pain-policy-related editorials and commentaries, particularly in regard to ethical, regulatory, forensic, and other legal issues in pain medicine, and to the education of pain practitioners and researchers.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信