Association of Arm Pain, Neck Pain, and Numbness Improvement with Patient Satisfaction During Pharmacological Treatment for Cervical Spine Disorders: A Prospective Multicenter Cohort Study

Study Design Prospective multicenter cohort study. Objectives To examine associations between improvements in arm pain, neck pain, numbness, and patient satisfaction during pharmacological treatment of cervical spine disorders. Methods Of 256 patients with cervical spine disorders and upper extremity symptoms enrolled at 28 institutions, 220 patients (830 observations) were included. A generalized estimating equation with cluster-robust variance regressed satisfaction (5-point Likert; satisfied ≥4) on improvement in arm pain, neck pain, and numbness (NRS 0–10), adjusting for psychosocial burden (BS-POP), age, sex, and time point. An ordinal model was used as an alternative outcome specification, and sensitivity analyses were interpreted descriptively. Results Arm pain improvement was associated with satisfaction under both binary (OR 1.095 per point, P =.022; Holm-adjusted P =.044) and ordinal (OR 1.143, P =.019) coding. Neck pain improvement was associated with satisfaction under binary coding only (OR 1.121, P =.003; Holm-adjusted P =.009; ordinal P =.447). Numbness improvement showed the same direction but was not significant in either specification (OR 1.068, P =.106; ordinal P =.377). Confidence intervals overlapped across domains, and the arm pain estimate was attenuated under inverse-probability weighting and in diagnostic subsets. Approximately one-third of observations with persistent numbness had satisfaction scores ≥4. Conclusions Arm pain improvement was consistently associated with greater satisfaction, whereas the association with numbness improvement was less consistent. Residual numbness alone should not be considered treatment failure and should be interpreted alongside pain relief, neurological findings, and overall clinical condition. These findings support multidimensional assessment of treatment response rather than reliance on residual numbness alone in clinical practice.

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Publication Details

Journal
Global Spine Journal
Published
2026-10-30
DOI
https://doi.org/10.1177/21925682261493432
Primary Topic
Musculoskeletal pain and rehabilitation
Type
article
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article

Association of Arm Pain, Neck Pain, and Numbness Improvement with Patient Satisfaction During Pharmacological Treatment for Cervical Spine Disorders: A Prospective Multicenter Cohort Study

Takashi Kaito, Shiro Imagama, Masashi Miyazaki, Yasuaki Imajo et al.
1 links
Global Spine Journal
Musculoskeletal pain and rehabilitation
article

Association of Arm Pain, Neck Pain, and Numbness Improvement with Patient Satisfaction During Pharmacological Treatment for Cervical Spine Disorders: A Prospective Multicenter Cohort Study

Takashi Kaito, Shiro Imagama, Masashi Miyazaki, Yasuaki Imajo, Masao Koda, Masayuki Miyagi, Hideyuki Arima, Takeo Furuya, Hirotaka Haro, Shunsuke Kanbara, Keiji Nagata, Akinobu Suzuki, Mitsuru Yagi, Toshitaka Yoshii, Yu Yamato, Norimitsu Wakao, Hiroaki Nakashima, Yukihiro Matsuyama, Michio Hongo, Sadayuki Ito, Hirotaka Chikuda, Hiroshi Hashizume, Masahiko Takahata, Iizuka Yoichi, Naohisa Miyakoshi, Gen Inoue, Kazuyoshi Kobayashi, Mikito Tsushima, Mamoru Kawakami, Hiroshi Miyamoto, 幹士 森, Satoshi Suzuki, Masaya Nakamura, Kei Watanabe, Masahiko Watanabe
article en

Abstract

Study Design Prospective multicenter cohort study. Objectives To examine associations between improvements in arm pain, neck pain, numbness, and patient satisfaction during pharmacological treatment of cervical spine disorders. Methods Of 256 patients with cervical spine disorders and upper extremity symptoms enrolled at 28 institutions, 220 patients (830 observations) were included. A generalized estimating equation with cluster-robust variance regressed satisfaction (5-point Likert; satisfied ≥4) on improvement in arm pain, neck pain, and numbness (NRS 0–10), adjusting for psychosocial burden (BS-POP), age, sex, and time point. An ordinal model was used as an alternative outcome specification, and sensitivity analyses were interpreted descriptively. Results Arm pain improvement was associated with satisfaction under both binary (OR 1.095 per point, P =.022; Holm-adjusted P =.044) and ordinal (OR 1.143, P =.019) coding. Neck pain improvement was associated with satisfaction under binary coding only (OR 1.121, P =.003; Holm-adjusted P =.009; ordinal P =.447). Numbness improvement showed the same direction but was not significant in either specification (OR 1.068, P =.106; ordinal P =.377). Confidence intervals overlapped across domains, and the arm pain estimate was attenuated under inverse-probability weighting and in diagnostic subsets. Approximately one-third of observations with persistent numbness had satisfaction scores ≥4. Conclusions Arm pain improvement was consistently associated with greater satisfaction, whereas the association with numbness improvement was less consistent. Residual numbness alone should not be considered treatment failure and should be interpreted alongside pain relief, neurological findings, and overall clinical condition. These findings support multidimensional assessment of treatment response rather than reliance on residual numbness alone in clinical practice.

Global Spine Journal
Tokai University (JP), University of Tsukuba (JP), Chiba University (JP), Shiga University of Medical Science (JP), Aichi Medical University (JP), Gunma University (JP), Oita University (JP), Wakayama Medical University (JP), Akita University (JP), Keio University (JP), Hokkaido University (JP), Hamamatsu University School of Medicine (JP), Konan Kosei Hospital (JP), Nagoya University Hospital (JP), Chubu Rosai Hospital (JP), Osaka Rosai Hospital (JP), Kobe Rosai Hospital (JP), Niigata University Medical and Dental Hospital (JP), Japanese Red Cross Nagoya Daini Hospital (JP), Osaka Metropolitan University (JP), Institute of Science Tokyo (JP), Tokuyama Central Hospital (JP), Nagoya University (JP), Kitasato University (JP), University of Yamanashi (JP), International University of Health and Welfare (JP)
Good health and well-being
Openalex Percentile: Top 13%
Musculoskeletal pain and rehabilitation
DOIOpen Access PDFOpenAlex
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