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The following is a summary of “Relationship Between Psychosocial Factors and Response to Epidural Steroid Injection for Chronic Lumbosacral Radicular Pain: A Prospective Pilot Study,” published in the April 2025 issue of Journal of Pain Research by Stensland et al. 

Researchers conducted a retrospective study to examine how psychosocial variables were associated with pain intensity following epidural steroid injections (ESIs) in individuals with chronic lumbosacral radicular pain.  

They evaluated a longitudinal cohort with repeated within-subject measures, collecting data at 5 timepoints: baseline before injection, immediately post-injection, at 6 weeks, 12 weeks, and 6 months. Pain intensity was the primary outcome, measured using the numeric rating scale (0–10) [numeric rating scale 0–10]. At each timepoint, individuals completed a set of self-reported assessments. Analyses were performed using principal component analysis and generalized linear mixed-effects modeling.  

The results showed that 40 individuals (mean age 52 ± 13.05 years) participated. Higher pre-injection pain scores were significantly associated with elevated pain ratings at all follow-up points (P < 0.001) [P < 0.001]. After adjusting for initial pain and demographic variables, individuals with baseline Negative Affect 1 standard deviation above the mean reported an average increase of 1.12 points in pain intensity at 12 weeks (95% CI: 0.18–2.07; P = 0.020) [95% CI: 0.18– 2.07; P =0.020]. In contrast, those with Cognitive Resilience 1 standard deviation above the mean reported a 1.12-point average decrease in pain intensity at 6 months (95% CI: −2.09 to −0.05; P = 0.040) [95% CI: − 2.09 − 0.05, P =0.040].  

Investigators concluded that individuals with elevated negative affect and reduced cognitive resilience experienced less pain reduction following ESIs, highlighting the need for larger studies to explore psychosocial influences on treatment response and support the value of multidisciplinary chronic pain management. 

Source: dovepress.com/the-relationship-between-psychosocial-factors-and-response-to-epidural-peer-reviewed-fulltext-article-JPR