Validation of self-reported pain reduction after diagnostic blockade

Area of Science:

• Pain Management
• Interventional Pain Medicine
• Spinal Injections

Background:

• Radiofrequency neurotomy recommendation often relies on short-term pain relief after facet block injections.
• Patient-reported outcomes are crucial for treatment guidance.
• Evaluating the concordance of different pain assessment scales is important for accurate patient assessment.

Purpose of the Study:

• To evaluate the concordance between the pain numerical rating scale (NRS) and the global perceived improvement (GPI) scale for assessing pain relief after facet blocks.
• To determine if retrospective recall influences patient-reported pain improvement.
• To inform the criteria for recommending radiofrequency neurotomy.

Main Methods:

• Retrospective cohort study design.
• Inclusion of patients who underwent medial branch facet blocks in cervical or lumbar regions.
• Collection of pain NRS (baseline, postprocedure, hourly up to 6 hours) and GPI scale data.

Main Results:

• The average percent improvement on the NRS at 6 hours was 21%, while the average GPI was 44%.
• A significant difference was observed between baseline NRS and NRS at 6 hours (P < 0.01).
• No demographic or baseline factors explained the discrepancy between NRS and GPI measures.

Conclusions:

• Retrospective patient pain relief reporting, particularly using the GPI scale, may be influenced by overall pain experience and recall.
• Multiple NRS measurements following treatment are important for accurate assessment of pain improvement.
• The findings suggest that relying solely on retrospective global assessments may be misleading for treatment decisions.