Long-Term Prospective Follow-Up of Spinal Interventional Pain Procedures and Physical Therapy Compliance on Outcomes in Chronic Pain Patients

Abstract

Background/Objective: The long-term implications of spinal interventional pain procedures (IPPs) remain underexplored. This study aimed to evaluate pain intensity, overall health quality, and disability over a four-year period following an IPP, while also assessing physical therapy (PT) compliance, the need for repeated procedures, and analgesic consumption. Methods: A prospective observational study with retrospective registration was conducted on patients with chronic spinal pain at Hamad Medical Corporation (HMC), Qatar. Patients were assessed using the Numeric Rating Scale (NRS), the Oswestry Disability Index (ODI), and the EuroQol 5-Dimension Index (EQ-5D). Additional tools included the EQ-Health Visual Analog Scale and the Patient Global Impression of Change (PGIC). Follow-ups were performed at 6, 12, 24, 36, and 48 months. Results: A total of 766 patients were initially recruited, of whom 174 met the inclusion criteria. All patients demonstrated significant improvement across all outcome measures compared to the baseline. No significant differences were observed in pain or functional outcomes between PT-compliant and non-compliant groups. By the end of this study, 56.9% of patients reported reduced analgesic use, while 43.1% reported increased use. The patient satisfaction data showed that 55% (62/113) of those receiving a single IPP were satisfied, compared to 54% (33/61) in the multiple IPP group. The PGIC satisfaction scores revealed no statistically significant differences (p = 1). Overall health status, as measured by the EQ-5D Health scale, also showed no meaningful differences between groups. Conclusions: Despite several limitations, patients reported sustained improvement and satisfaction four years post-IPP. PT compliance did not appear to significantly influence long-term outcomes. Further research is needed to identify factors affecting post-IPP recovery and medication usage.