Psychopathology and Pain Relief from Medial Branch Blocks
Author Information
Author(s): Wasan Ajay D, Jamison Robert N, Pham Loc, Tipirneni Naveen, Nedeljkovic Srdjan S, Katz Jeffrey N
Primary Institution: Brigham & Women's Hospital and Harvard Medical School
Hypothesis
Patients with high levels of depression and anxiety symptoms would have a diminished response to a therapeutic MBB compared with those with little psychiatric comorbidity.
Conclusion
Psychiatric comorbidity is associated with diminished pain relief after a MBB injection performed with steroid at one-month follow-up.
Supporting Evidence
- The Low psychopathology group reported a mean of 23% improvement in pain, while the High psychopathology group reported a mean worsening of -5.8%.
- 45% of the Low group had at least 30% improvement in pain versus 10% in the High group.
- Psychopathology group remained as the only significant predictor of outcome.
Takeaway
If someone is feeling really sad or anxious, they might not feel better after a pain injection for their back or neck, while those who feel okay might feel a lot better.
Methodology
This was a prospective cohort study where patients undergoing MBBs were assessed for levels of psychopathology and pain improvement was measured one month after the procedure.
Potential Biases
The study may have selection bias due to the low follow-up rate.
Limitations
Only 52% of participants completed the follow-up, which may introduce selection bias.
Participant Demographics
The study included 86 subjects with varying levels of psychopathology, with 34% classified as High psychopathology.
Statistical Information
P-Value
<0.001
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website