OBJECTIVE: Investigate the relationship between socioeconomic status (SES) and pain reduction from epidural steroid injections (ESIs) for lumbar radiculopathy. METHODS: The retrospective cohort consisted of patients undergoing ESI for lumbar radiculopathy (n = 544). Numeric pain rating scale (NPRS) was measured at baseline and two weeks post-ESI. SES was estimated using median family income in patients' ZIP code. Linear and mixed models examined demographic and clinical differences in pain pre- and post-injection and whether family income moderated the effect. RESULTS: Majority of patients were white (72.4%), female (56.4%), engaged in physical activity (68.2%), and underwent unilateral, transforaminal ESI (86.0%, and 92.1%, respectively). Non-white patients and those who did not engage in physical activity had higher baseline pain (p < 0.05)). Lower SES was associated with higher baseline pain (β = 0.06 per $10,000p = 0.01). Patients with lower SES experienced larger improvement in pain following ESI:-1.56 units for patients in the 10th percentile of family income versus -0.81for 90th percentile. Being a current smoker was associated with higher pain (β = 0.76 p = 0.03) and engaging in structured physical activity less pain (β = -0.07 p < 0.01). CONCLUSIONS: Lower SES was independently associated with higher pain alleviation after controlling for other potentially influential demographics. Modifiable lifestyle factors maybe a target of potential intervention.
OBJECTIVE: Investigate the relationship between socioeconomic status (SES) and pain reduction from epidural steroid injections (ESIs) for lumbar radiculopathy. METHODS: The retrospective cohort consisted of patients undergoing ESI for lumbar radiculopathy (n = 544). Numeric pain rating scale (NPRS) was measured at baseline and two weeks post-ESI. SES was estimated using median family income in patients' ZIP code. Linear and mixed models examined demographic and clinical differences in pain pre- and post-injection and whether family income moderated the effect. RESULTS: Majority of patients were white (72.4%), female (56.4%), engaged in physical activity (68.2%), and underwent unilateral, transforaminal ESI (86.0%, and 92.1%, respectively). Non-white patients and those who did not engage in physical activity had higher baseline pain (p < 0.05)). Lower SES was associated with higher baseline pain (β = 0.06 per $10,000p = 0.01). Patients with lower SES experienced larger improvement in pain following ESI:-1.56 units for patients in the 10th percentile of family income versus -0.81for 90th percentile. Being a current smoker was associated with higher pain (β = 0.76 p = 0.03) and engaging in structured physical activity less pain (β = -0.07 p < 0.01). CONCLUSIONS: Lower SES was independently associated with higher pain alleviation after controlling for other potentially influential demographics. Modifiable lifestyle factors maybe a target of potential intervention.
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