The Influence of Pain Sensitivity on the Treatment Outcome of Transforaminal Epidural Steroid Injection in Patients with Lumbar Spinal Stenosis

Abstract

The aim of this study was to investigate the effect of individual pain sensitivity on the results of transforaminal epidural steroid injection (TFESI) for the patients with lumbar spinal stenosis (LSS). Seventy-seven patients with LSS were included in this study. Prospectively planned evaluations were performed twice consecutively before and 2 months after TFESI. These included a detailed medical history, a physical examination, and completion of a series of questionnaires, including pain sensitivity questionnaire (PSQ), Oswestry disability index (ODI), and visual analog scale (VAS) for back and leg pain. The correlations were analyzed among variables between total PSQ/PSQ-moderate/PSQ-minor and pain and disability level measured by VAS for back/leg pain and ODI both before and 2 months after TFESI. Two months after TFESI, there were significant decreases in VAS for back/leg pain and ODI compared with those before injection. Before injection, VAS for back pain and leg pain was highly associated with the PSQ scores including total PSQ and PSQ subscores after adjustment for age, BMI, and grade of canal stenosis. However, any subscores of PSQ and total PSQ scores were not correlated with either VAS for back pain/leg pain or ODI 2 months after TFESI with adjustment made to age, BMI, gender, and grade of canal stenosis. This study highlights that individual pain sensitivity does not influence the outcomes of TFESI treatment in patients with LSS, even though pain sensitivity has a significant negative correlation with symptom severity of LSS.

Influence of Educational Attainment on Pain Intensity and Disability in Patients With Lumbar Spinal Stenosis

“…[3][4][5] Abundant evidence has shown that biomedical factors cannot fully explain the chronic pain in musculoskeletal disorders. 6 , 7 Recently, it has been thought that psychosocial and environmental factors might have a potential causal relationship with chronic pain and the related disability.…”

Structural Consistency of the Pain Sensitivity Questionnaire in the Cooperative Health Research In South Tyrol (CHRIS) Population-Based Study

“…38 Interviewees are asked to rate items of the PSQ that reflect imagined, typically painful stimuli. The PSQ has been used in different clinical and population-based settings 16,[22][23][24][25][26][27]37,39,43 and is available in several languages. 3,23,27,32,43,48 The PSQ showed good test-retest reliability in healthy volunteers 38 and clinical samples with degenerative spinal disease.…”

At Least 5‐Year Follow‐up After Transforaminal Epidural Steroid Injection Due to Lumbar Radicular Pain Caused by Spinal Stenosis

“…The short‐term positive effectiveness of TFESI for controlling radicular pain following LSS has been well demonstrated in several previous studies 7,11–14 . However, the long‐term outcome of TFESI on LSS has been rarely studied.…”

“…Additionally, it can block the transmission of nociceptive signals through the nerve fibers 10 . The short‐term pain‐reducing effects of lumbar TFESI is well demonstrated 7,11–14 . However, little is known about the long‐term effect of lumbar TFESI for managing lumbar radicular pain due to LSS.…”