Relationship Between Socioeconomic Status and the Outcome of Lumbar Epidural Steroid Injections for Lumbar Radiculopathy.
Prakash Jayabalan, Rachel Bergman, Kevin Huang and 2 others
PMID 35383580WHAT IT FOUND
Patients with lower estimated family income had higher baseline pain but experienced a larger reduction in pain scores two weeks after a lumbar epidural steroid injection than those with higher income.
Physical activity was linked to lower baseline pain and better outcomes.
Key findings
01Patients in the 10th percentile for median family income had a 1.56-point reduction in pain scores, whereas those in the 90th percentile had a 1.13-point reduction.
02Patients with lower estimated family income presented with higher pain scores on average, at 0.06 points higher per every $10,000 less in estimated family income.
03Engaging in structured physical activity was associated with lower pain scores overall compared to being not physically active.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study is retrospective and observational, meaning it cannot prove that income causes differences in pain response. The sample had a median estimated family income of $118,888.50, which is almost double the national median, limiting generalizability to lower-income populations. Follow-up was short (two weeks), so long-term effects on pain were not assessed. Socioeconomic status was estimated using ZIP code data, which may not accurately capture individual financial circumstances. The study did not account for prior or ongoing treatments such as physical therapy, which could influence outcomes. Only 544 of 780 eligible patients were analyzed because two-week follow-up data were missing for 236 patients.
Declared interests
The study was supported by the National Institutes of Health (NIH). No other conflicts of interest are reported in the text.
The easy way to misread this
Do not interpret the difference in pain reduction (1.56 points vs 1.13 points) as clinically significant. The authors note that statistical differences between income percentiles may not represent clinical significance, and the overall effect size is small.