Evidence map›Paper›PMID 40896548›Full record

ArticleInterventional pain medicine2025

"Is this injection going to hurt?" Quantifying the pain experience during common lumbosacral spine injections.

Asher Smuek, Rishi Bakshi, Romeo Mays, Lisa Huynh, Joshua Levin, Joshua Rittenberg, Matthew Smuck

Abstract read
In one paragraph

Article in Interventional pain medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Asher SmuekDivision of PM&R, Department of Orthopaedic Surgery, Stanford University, 450 Broadway St., Redwood City, CA, USA.
Rishi BakshiDepartment of PM&R, University of Michigan, Ann Arbor, MI, USA.
Romeo MaysPhiladelphia College of Osteopathic Medicine, Philadelphia, PA, USA.
Lisa HuynhDivision of PM&R, Department of Orthopaedic Surgery, Stanford University, 450 Broadway St., Redwood City, CA, USA.
Joshua LevinDivision of PM&R, Department of Orthopaedic Surgery, Stanford University, 450 Broadway St., Redwood City, CA, USA.
Joshua RittenbergDivision of PM&R, Department of Orthopaedic Surgery, Stanford University, 450 Broadway St., Redwood City, CA, USA.
Matthew SmuckDivision of PM&R, Department of Orthopaedic Surgery, Stanford University, 450 Broadway St., Redwood City, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: "Is this injection going to hurt?" Physicians typically answer this from experience since accurate answers are not available in the literature. Objective: To quantify pain during common lumbosacral spine injections and compare to baseline pain prior to the injections. Analyze differences based on demographic and procedure variables. Methods: This is a secondary analysis of prospectively collected data from a multicenter trial of patients undergoing bilateral symmetric transforaminal epidural (TFE), facet joint (FJ), or sacroiliac joint (SIJ) injections. Numeric pain ratings (0-10) were obtained at baseline in preop ("What is your current pain?") and for each injection procedure ("How much did this injection hurt from start to finish?") first on the right side then the left. Between group comparisons used Chi-squared and ANOVA for categorical and continuous variables, respectively. T-tests compared various pain responses, and multivariate regression determined factors associated with higher procedure pain. Results: From 244 injections (124 TFE, 60 FJ, 60 SIJ) on 122 consecutive patients (mean age 57.2, 50 % female), age and BMI did not differ between injection groups while sex did (p = 0.001) with more FJ males and SIJ females. Mean baseline pain was statistically equivalent between demographic and injection groups. Mean procedure pain was consistently higher than mean baseline pain, however this difference was small and non-significant for TFE (4.0 vs 3.8) and FJ (3.9 vs 3.3), but larger and significant for SIJ (5.3 vs. 3.6; p = 0.0001). In the multivariate regression analysis only 2 variables remained associated with higher procedure pain, older age (p < 0.0001) and SIJ injection group (p = 0.0021). Conclusion: The majority of patients (79.1 %) report mild or moderate pain during common lumbosacral spine injections. The average procedure pain of 4.3 on the NPRS scale was only 0.7 points higher than baseline pain recorded in pre-op. Procedure pain from TFE and FJ injections is statistically equivalent to baseline pain and to each other, while SIJ injections produce higher procedure pain with a significant +1.7 point mean increase in pain from baseline. Finally, older adults report significantly greater procedure pain compared to those under 65 years old.

Indexed as

DiscomfortExpectationsInjectionPatientSpine

Identifiers

PMID40896548
PMCPMC12396260

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.