Impact of Spinal Injections on Health-Behavior Changes in Chronic Low Back Pain Patients: A One-Year Longitudinal Study

Abstract

Background: Inappropriate health behaviors, including poor nutritional habits, insufficient physical activity, and non-ergonomic practices, are major contributors to chronic or recurrent low back pain. Spinal injection is a widely used minimally invasive treatment for low back pain; however, its association with changes in these health behaviors remains unclear. Objectives: We aimed to evaluate changes in health behaviors related to low back pain following spinal interventions and to assess the efficacy and safety of spinal injections. Methods: This single-arm, before-after longitudinal study included 153 adults (mean age, 50.97 ± 13.95 years; 65% female) with chronic low back pain due to lumbar disc herniation, spinal stenosis, sacroiliac joint dysfunction, or a combination of these conditions, who underwent spinal injections. Participants completed standardized questionnaires before the intervention and 1 year afterward to assess changes in dietary habits, physical activity, and ergonomic behavior. Pain severity was assessed using the Numeric Rating Scale (NRS; 0 - 10). Results: Pain severity and dietary, physical activity, and ergonomic behaviors changed significantly after injection (P < 0.001). Furthermore, the number of patients taking any type of analgesic (P = 0.001) and the number of patients receiving physical therapy (P < 0.001) decreased significantly after injection, whereas the frequency of analgesic consumption showed a decreasing trend that did not reach statistical significance (P = 0.06). Conclusions: Improvements in health behaviors were observed after spinal injections among patients with chronic low back pain. However, owing to the single-arm before-and-after design, causal relationships between spinal injections and behavioral changes cannot be confirmed.