SUMMARY OF BACKGROUND DATA:Multiple clinical trials have demonstrated the effectiveness of intraosseous basivertebral nerve radiofrequency ablation (BVNA) for treating chronic vertebrogenic low back pain (vLBP). Few studies have evaluated the effectiveness in a real-world population. OBJECTIVES:To evaluate the effectiveness of BVNA for vLBP in a real-world population. METHODS:A single-arm prospective cohort study of patients with LBP ≥ 6 months and Type 1 or Type 2 Modic changes on MRI. The primary outcome was mean improvement in Oswestry Disability Index (ODI) post-BVNA. Secondary outcomes included the proportion of participants with (1) ≥30% and ≥15-point ODI improvements, (2) ≥2-point and ≥50% reductions in pain on Numerical Rating Scale (NRS), and (3) ≥ "much improved" on Patient Global Impression of Change (PGIC) at 3- and 12-month follow-up. RESULTS:In total, 60 participants were included (mean age 57.0 ± 13.4 years; 45.0% female). Mean ODI score improvement was 13.9 ± 18.7 and 14.0 ± 15.7 points at 3- and 12-month follow-up, respectively. At 12 months, 52.8% (95% CI, 39.7-65.6) of participants reported ≥30% ODI improvement and 39.6% (95% CI, 27.6-53.1) of participants reported ≥15-point improvement in ODI. Twelve-month responder rates for ≥2-point and ≥50% NRS improvement were 67.9% (95% CI, 54.5-78.9) and 49.1% (95% CI, 36.1-62.1). Moreover, 54.7% (95% CI, 41.5-67.3) of participants reported being "much or very much improved" on the PGIC at 12 months. DISCUSSION/CONCLUSION:In this real-world cohort, over half of participants with vLBP experienced clinically meaningful improvements in pain and function at 12-month post-BVNA. TRIAL REGISTRATION DETAILS:ClinicalTrials.gov (original study: NCT04449835; continuation study: NCT05660512); [original study: June 25, 2020; continuation study: December 13, 2022].

BACKGROUND:Radicular symptoms from lumbosacral spinal stenosis (LSS) are commonly managed with conservative measures, including transforaminal epidural steroid injection (TFESI). However, repeated use may cause systemic side effects in some patients. Human amniotic fluid filtrate (hAF), containing anti-inflammatory, neuroprotective, and regenerative factors, has shown therapeutic potential in pre-clinical models and other medical conditions. OBJECTIVES:Compare the safety and effectiveness of transforaminal epidural injections with hAF versus dexamethasone for treating radicular pain from LSS. DESIGN:Double-blinded, prospective, randomized comparative trial. METHODS:Fifty-eight participants were included, with outcomes assessed at 3 weeks, 6 weeks, 3 months (primary endpoint), and 6 months. Primary outcomes were adverse events (AEs) and proportions of participants reporting ≥50% numerical pain rating scale (NPRS) back and leg pain reductions at 3 months. Secondary outcomes included Oswestry Disability Index (ODI), Swiss Spinal Stenosis Questionnaire (SSSQ), and PROMIS Physical Health Summary (PHS). Linear mixed-effects models evaluated between-group differences while accounting for repeated measures. RESULTS:At 3 months, a significantly greater proportion of participants receiving dexamethasone achieved ≥50% reductions in back pain (45.8% [95%CI = 27.9%-64.9%] vs. 15.0% [95%CI = 5.2%-36.0%]; P = .050) and leg pain (60.0% [95%CI = 40.7%-76.6%] vs. 25.0% [95%CI = 11.2%-46.9%]; P = .034) compared with hAF. Secondary outcome trends similarly favored dexamethasone at 3 months. Mixed-effects models showed greater improvements to 6-week pain and function scores with dexamethasone relative to hAF. Group AE rates were comparable, and no serious intervention-related AEs occurred. CONCLUSION:Dexamethasone demonstrated significantly greater short- and intermediate-term benefits over hAF across multiple clinical outcome domains for radicular pain due to LSS, prompting early trial discontinuation. TRIAL REGISTRATION:ClinicalTrials.gov (NCT04537026); September 3, 2020.

OBJECTIVE:To describe long-term treatment outcomes of nervus femoralis radiofrequency ablation (NF-RFA) for recalcitrant greater trochanteric pain syndrome (GTPS). DESIGN:A cross-sectional study. METHODS:Chart review of consecutive patients who underwent NF-RFA from 2022 to 2023 was performed. A standardized telephone survey was utilized to capture current Numeric Pain Rating Scale (NPRS) and Patient Global Impression of Change (PGIC) scores. The primary outcome was ≥50% NPRS score reduction at follow-up. A secondary analysis was completed on free text responses asking patients to describe post-procedural changes in pain and function in their own words. RESULTS:Outcomes were collected from 25 patients (aged 71.7 ± 9.3 years; 80.0% female; body mass index 29.3 ± 6.8 kg/m2) for 27 NF-RFA procedures at a minimum follow-up time of 6 months post-procedure. Average follow-up time was 13.1 ± 4.9 months; ≥50% NPRS reduction from baseline was reported by 55.6% (n = 15/27; 95% CI, 37.3-72.4) of patients. In addition,  ≥ 2-point NPRS score reduction from baseline was reported by 70.4% (n = 19/27; 95% CI, 51.5-84.2) of patients, and 51.9% (n = 14/27; 95% CI, 34.0-69.3) reported a PGIC score consistent with "much improved" or "very much improved." CONCLUSION:In this cohort, over 55% of patients who received NF-RFA as treatment for refractory GTPS reported at least 50% improvement in hip pain at an average follow-up of approximately 13 months. The majority of free text responses from patients indicated that they would recommend NF-RFA, while approximately 25% reported ongoing pain and disability from low back pain or a return of index hip pain symptoms post-procedure.

BACKGROUND CONTEXT Clinical trials have demonstrated the efficacy and effectiveness of interosseous basivertebral nerve radiofrequency ablation (BVNA) for treating vertebrogenic chronic low back pain (vLBP). However, substantially fewer studies have evaluated the effectiveness of this treatment in a real-world population. PURPOSE Evaluate the effectiveness of BVNA as treatment for vLBP, including patients with dominant vLBP versus vLBP with concomitant pain sources. STUDY DESIGN/SETTING Single-arm prospective cohort study. PATIENT SAMPLE Patients aged 32-79 years with LBP of ≥ 6 months duration accompanied by Type 1 or 2 Modic changes on MRI. OUTCOME MEASURES The primary outcome was mean improvement in Oswestry Disability Index (ODI) score at 3-months post BVNA. Secondary outcomes included the proportion of participants with (1) ≥30% and ≥15-point ODI improvements, (2) ≥2-point and ≥50% reductions in Numerical Rating Scale (NRS), (3) at least “much improved” on Patient Global Impression of Change (PGIC), and (4) opioid utilization at 3- and 12-month follow-up. METHODS Patients who received BVNA from 2020-2023 at a single tertiary academic center were approached for participation. Demographic and procedural data were collected from electronic medical records and baseline study visits, with outcomes assessed via telephone follow-up. Participants were categorized as having dominant vLBP versus multifactorial low back pain (mLBP) that necessarily included vLBP. RESULTS A total of 60 participants were included (mean age 57.0±13.4 years; 45% female): 16 (26.7%) had dominant vLBP, while 44 (73.3%) had mLBP. Mean ODI score improvement was 13.9±18.7 and 14.0±15.7 points at 3- and 12-month follow-up, respectively, with average improvements of 15.1±18.2 and 13.6±14.9 points for the dominant vLBP and mLBP subgroups at 12 months. At 12-months, 52.8% (95%CI: 39.7-65.6) of participants reported >30% improvement in ODI, including 57.1% (95%CI: 32.6-78.6) with dominant vLBP and 51.3% [95%CI: 36.2-66.1] with mLBP). At 12-months, The proportion 39.6% (95%CI: 27.6-53.1) of participants achieved a ≥15-point improvement in ODI, including 42.9% (95%CI: 21.4-67.4) with dominant vLBP and 38.5% [95%CI: 24.9-54.1] with mLBP). 12-month responder rates for >2-point and ≥50% NRS improvement were 67.9% (95%CI: 54.5-78.9) and 49.1% (95%CI: 36.1-62.1) overall, 50.0% (95%CI: 26.8-73.2) and 50.0% (95%CI: 26.8-73.2) for the dominant vLBP group, and 74.4% (95%CI: 58.9-85.4) and 48.7% (95%CI: 33.9-63.8) for the mLBP group. The proportion of participants who reported “much or very much improved” on PGIC at 12 months was 54.7% (95%CI: 41.5-67.3) overall (71.4% [95%CI: 45.4-88.3] dominant vLBP vs 48.7% [95%CI: 33.9-63.8] mLBP). At baseline, 36.7% (95%CI: 25.6-49.3) of participants reported active opioid use (25.0% [95%CI: 10.2-49.5] with dominant vLBP versus 40.9% [95%CI: 27.7-55.6] with mLBP). At 12-months, 34.0% (95%CI: 22.7-47.4) reported active opioid use, (35.7% [95%CI: 16.3-61.2] with dominant vLBP versus 33.3% [95%CI: 20.6-49.0] with mLBP). CONCLUSIONS In this real-world cohort, over half of participants with vLBP experienced clinically meaningful improvements in pain and function at 12-month post-BVNA. While no intergroup differences achieved statistical significance, responder rates for ODI and PGIC were higher among the dominant vLBP group compared to those with mLBP in this cohort. FDA Device/Drug Status This abstract does not discuss or include any applicable devices or drugs.

BACKGROUND:Radiofrequency ablation (RFA) of neuromas has emerged as a potential treatment option for refractory neuroma-associated postamputation pain (PAP). OBJECTIVE:To evaluate the feasibility of using internally cooled radiofrequency ablation (C-RFA) for treating neuroma-associated PAP. DESIGN:Prospective single-arm pilot study. SETTING:Tertiary academic medical center. PARTICIPANTS:Eight participants with neuroma-associated PAP (mean age 56.5 [interquartile range, 50.5-68.5] years; mean body mass index 30.2 [interquartile range, 26.3-34.8] kg/m2). INTERVENTION:Participants were recruited and treated with C-RFA between 2019 and 2023. MAIN OUTCOME MEASURES:Pain and functional outcomes were assessed at 1, 3, 6, and 12 months after C-RFA using Numeric Rating Scale (NRS), Groningen Activity Restriction Scale (GARS), Patient Global Impression of Change (PGIC), and Medication Quantification Scale III (MQS-III). Responder definitions for each outcome measure were ≥50% NRS reduction, ≥30% GARS improvement, ≥6 on PGIC, and ≥6.8-point MQS-III reduction. RESULTS:NRS responder rates at 1, 3, 6, and 12 months were 25.0% (95% CI, 7.0%-59.1%), 50.0% (95% CI, 21.5%-78.5%), 37.5% (95% CI, 13.7%-69.4%), and 50.0% (95% CI, 21.5%-78.5%), respectively. Responder rates for GARS were 25.0% (95% CI, 7.1%-59.1%) at 1 month and 12.5% (95% CI, 2.2%-47.1%) at 3, 6, and 12 months. The proportion of PGIC responders was 37.5% (95% CI, 13.7%-69.4%) at 1 and 3 months and 12.5% (95% CI, 2.2%-47.1%) at 6 and 12 months. MQS-III responder rates were 25.0% (95% CI, 7.1%-59.1%) at 1 month, 12.5% (95% CI, 2.2%-47.1%) at 3 months, and 37.5% (95% CI, 13.7%-69.4%) at 6 and 12 months. There were no complications associated with the C-RFA procedure. CONCLUSIONS:These findings indicate the feasibility of neuroma C-RFA as a treatment for refractory neuroma-associated PAP but also suggest that further patient selection and C-RFA technique optimization are warranted before investigating this treatment paradigm in a larger prospective study.

BACKGROUND:Lumbar medial branch radiofrequency ablation (LRFA) and intraarticular facet steroid injections (FJI) are commonly performed for recalcitrant facet joint-mediated pain. However, no study has compared clinical outcomes of the two treatments in patients selected using dual medial branch blocks (MBBs) with an 80% relief threshold. OBJECTIVE:Compare the effectiveness of cooled LRFA (C-LRFA) to FIJ as assessed by pain and functional improvements. DESIGN:Prospective randomized comparative trial. METHODS:Patients with dual MBB-confirmed facet joint-mediated pain were randomized to receive C-LRFA or FIJ. Outcomes were assessed at 1, 3, 6, and 12 months. The primary outcome was ≥50% improvement in numerical pain rating scale (NPRS) score at 3 months. Secondary outcomes included ≥30% Oswestry Disability Index (ODI) improvement and Patient Global Impression of Chance (PGIC) ≥6 points, among others. Data were analyzed using contingency tables and mixed-effects logistic regression models. RESULTS:Of 1128 patients screened, 32 met eligibility criteria, were randomized, and received their allocated study treatment. In total, 20 (62.5%) and 12 (37.5%) participants received C-LRFA and FIJ, respectively. In the C-LRFA group, 70% (95% CI 48-85), 55% (95% CI 34-74), and 45% (95% CI 26-66) of participants met the NPRS responder definition, compared to 25% (95%CI 9-53), 25% (95% CI 9-53), and 17% (95% CI 5-45) in the FJI group at 3, 6, and 12 months, respectively (P = .014 at 3 months). The PGIC responder proportion was higher in the C-LRFA compared to FJI group at 3 and 6 months (P < .05). CONCLUSIONS:C-LRFA demonstrated superior success rates compared to FJI across pain and functional outcome domains. TRIAL REGISTRATION DETAILS:ClinicalTrials.gov (NCT03614793); August 3, 2018.

OBJECTIVE:The aim of the study is to assess risk of common musculoskeletal disorders (MSDs) based on cardiovascular disease (CVD) risk scores.METHODS:Data from a 9-year prospective cohort of 1224 workers in three states were analyzed. Baseline data included questionnaires, structured interviews, physical examinations, anthropometric measurements, nerve conduction studies, and individualized measurement of job physical factors. Monthly follow-ups were conducted. Framingham risk scores were calculated. A priori case definitions were constructed for carpal tunnel syndrome, lateral epicondylopathy, medial epicondylopathy, and rotator cuff tendinopathy.RESULTS:Adjusted RRs for one or more MSDs increased to 3.90 (95% confidence interval, 2.20-6.90) among those with 10-year cardiovascular disease risk scores greater than 15% and 17.4 (95% confidence interval, 3.85-78.62) among those with more than 4 disorders.CONCLUSIONS:Cardiovascular disease factors are strongly associated with the subsequent development of common MSDs. Risks among those with multiple MSDs are considerably stronger.

BACKGROUND:Cervical medial branch radiofrequency ablation (CMBRFA) is an effective treatment for facetogenic pain in patients selected by Spine Intervention Society (SIS) guidelines of 100% symptom improvement with dual medial branch blocks (MBBs) ± placebo block. Patient selection for CMBRFA using ≥80% symptom improvement after dual concordant MBBs is common; however, this has not been studied.OBJECTIVE:To evaluate the effectiveness of CMBRFA and compare outcomes in individuals selected by 80-99% vs 100% symptom improvement with dual concordant MBBs.DESIGN:Cross-sectional cohort study.METHODS:Medical records of 87 consecutive patients were reviewed; 50 met inclusion criteria. A standardized telephone survey was performed at six or more months post-CMBRFA to query numerical rating scale (NRS) pain and patient global impression of change (PGIC) scores. The primary outcomes were the proportion of patients reporting ≥50% reduction of index pain.RESULTS:At a mean follow-up time of 16.9 ± 12.7 months, 54% (95% confidence interval [CI] = 35-73%) and 54% (95% CI = 32-74%) of the 80-99% and 100% MBBs groups, respectively, reported ≥50% pain reduction. Between-group comparison showed a relative risk of 0.99 (95% CI = 0.59-1.66) for meeting the primary outcome. Seventy percent (95% CI = 56-81%) of patients reported a PGIC score consistent with "improved or very much improved" at follow-up.CONCLUSIONS:CMBRFA is an effective treatment in patients who report ≥80% symptom relief with dual concordant MBBs. The present study demonstrated an overall ≥50% pain reduction rate of 54% and no significant difference between those selected by 80-99% vs 100% symptom relief with dual concordant MBBs.

Background:Lumbosacral transforaminal epidural steroid injection (LTFESI) is a commonly performed intervention for treating radicular pain. While factors that predict pain improvement after LTFESI have been evaluated, minimal literature exists regarding predictors of functional improvement. Purpose:To identify factors that are associated with functional improvement at short-term follow-up after LTFESI. Study design:Retrospective review of prospectively collected registry data. Patient sample:Patients undergoing LTFESI at an academic spine center who completed an Oswestry Disability Index (ODI) questionnaire both pre-procedure and one to three weeks post-procedure. Outcome measures:The outcomes of interest were the proportions of patients who experienced a minimal clinically important difference (MCID) in function defined as ​≥ ​30% improvement in ODI score, as well as ​≥ ​10-point and ≥15-point improvement in ODI score. Methods:Logistic regression analysis was performed to examine the associations of predictor variables to the ODI responder/non-responder outcome variable. The predictor variables for the analysis included: age, baseline ODI score, Charleston Comorbidity Index (CCI), payer type, prior lumbosacral spine surgery, pre-injection opioid use, two-level injections, bilateral injections, repeat injection, trainee presence during injection, immediate numerical rating scale (NRS) change post-injection. An odds ratio (OR) and its 95% confidence intervals (CIs) were calculated. Results:A total of 606 patients were included in the analysis. More than half of the patients (56.8%) reported a ≥7.1% improvement in ODI score, and about 30% reported a ≥30% improvement in ODI score. Approximately 36% and 20% of the patients reported ≥10-point and ≥15-point reductions in ODI score, respectively. Medicaid and Medicare payer type and pre-injection opioid use were significantly associated with a lower likelihood of ≥30%, and ≥15-point improvements in ODI, after adjusting for the other factors (p ​< ​0.05). Conclusions:When using various common definitions of MCID for ODI score improvement, Medicaid, Medicare, and pre-injection opioid use were identified as factors that are negatively associated with functional improvement at short-term follow-up after LTFESIs.

OBJECTIVES:Compare the effectiveness of catheter-directed cervical interlaminar epidural steroid injection (C-CIESI) with triamcinolone to cervical transforaminal steroid injection (CTFESI) with dexamethasone for the treatment of refractory unilateral radicular pain.DESIGN:Prospective, randomized, comparative trial.METHODS:Primary outcome: proportion of participants with ≥50% numeric rating scale pain score reduction from baseline "dominant pain" (the greater of arm vs neck) at one month postinjection. Secondary outcomes: ≥30% Neck Disability Index (NDI-5) reduction and Patient Global Impression of Change (PGIC) response indicating "much improved" or "very much improved."RESULTS:One hundred twenty participants (55.6% females, 52.3 ± 12.5 years of age, BMI 28.2 ± 6.5 kg/m2), were enrolled. The proportions of participants who experienced ≥50% pain reduction at one, three, and six months were 68.5% (95% CI = 54.9-79.5%), 59.3% (95% CI = 45.7-71.6%), and 60.8% (95% CI = 46.7-73.2%), respectively, in the C-CIESI group compared with 49.1% (95% CI = 36.4-62.0%), 46.4% (95% CI = 33.8-59.6%), and 51.9% (95% CI = 38.4-65.2%), respectively, in the CTFESI group. The between-group difference at one month was significant (P = 0.038). The proportions of participants who experienced a ≥30% NDI-5 score improvement were 64.0% (95% CI = 49.8-76.1%) and 54.9% (95% CI = 41.1-68.0%) in the C-CIESI and CTFESI groups (P = 0.352). Participants reported similar PGIC improvement in both groups: At six months, 53.2% (95% CI 38.9-67.1%) and 54.5% (95% CI = 39.7-68.7%) of the C-CIESI and CTFESI groups reported being "much improved" or "very much improved," respectively (P = 0.897).CONCLUSIONS:Both C-CIESI with triamcinolone and CTFESI with dexamethasone are effective in reducing pain and disability associated with refractory unilateral cervical radiculopathy in a substantial proportion of participants for at least six months.

OBJECTIVES:The objective of this study was to evaluate the long-term effectiveness of catheter-directed cervical interlaminar epidural steroid injection with triamcinolone compared with cervical transforaminal steroid injection with dexamethasone for the treatment of refractory unilateral radicular pain.DESIGN:Prospective, randomized, comparative trial.METHODS:The primary outcome was the proportion of participants with ≥50% Numeric Rating Scale 'dominant pain' (the greater of arm vs neck) reduction from baseline. Secondary outcomes included ≥30% Neck Disability Index reduction and Patient Global Impression of Change response indicating 'much improved' or 'very much improved'.RESULTS:Data from 117 participants (55.6% women; 52.3±12.5 years of age; body mass index, 28.2±6.5 kg/m2) were analyzed. The proportion of participants who experienced ≥50% pain reduction at 1 month, 3 months, and 6 months has been previously reported. At 1 year, 61.2% (95% CI, 46.9% to 73.9%) of the catheter group compared with 51.9% (95% CI, 38.4% to 65.2%) of the transforaminal group reported ≥50% 'dominant' pain reduction (p=0.35). The proportion of participants who experienced ≥30% improvement in Neck Disability Index score was 60.4% (95% CI, 45.9% to 73.3%) and 47.1% (95% CI, 33.7% to 60.8%) in the catheter and transforaminal groups (p=0.18). Patient Global Impression of Change improvement was similar in both groups: 60.5% (95% CI, 44.2% to 74.8%) and 57.5% (95% CI, 41.7% to 71.9%) of the catheter and transforaminal groups reported being 'much improved' or 'very much improved', respectively (p=0.79).CONCLUSION:Both cervical catheter-directed interlaminar epidural injection and cervical transforaminal steroid injection were effective in reducing pain and disability in the majority of participants with refractory unilateral cervical radiculopathy for up to 1 year.

SUMMARY OF BACKGROUND DATANo study has evaluated the relationship between contrast dispersion patterns and outcomes after fluoroscopically guided cervical transforaminal epidural steroid injection (CTFESI).OBJECTIVESDetermine whether contrast dispersion patterns predict pain and functional outcomes after CTFESI.METHODSSecondary analysis of data collected during two prospective studies of CTFESI for the treatment of refractory radicular pain. Contrast dispersion patterns visualized by true anteroposterior (AP) projections during CTFESIs were categorized by flow: 1) completely external to the lateral border of the neuroforamen (zone 1); 2) within the neuroforamen but without entry into the lateral epidural space (zone 2); and 3) with extension into the lateral epidural space (zone 3). At baseline and at 1 month post-CTFESI, neck pain, arm pain, and "dominant index pain" (the greater of arm or neck pain) were evaluated using a numeric rating scale (NRS); physical function was assessed using the Five-Item Version of the Neck Disability Index (NDI-5).RESULTSOne-month post-CTFESI, neck pain, arm pain, and "dominant index pain" reductions of ≥50% were observed in 39.4% (95% confidence interval [CI], 28.2-51.8), 55.6% (95% CI, 43.0-67.5), and 44.1% (95% CI, 32.7-56.2) of participants, respectively. Regarding "dominant index pain," 72.7% (95% CI, 40.8-91.2), 39.4% (95% CI, 24.2-57.0), and 37.5% (95% CI, 20.5-58.2) of participants reported ≥50% pain reduction when zone 1, zone 2, and zone 3 contrast flow patterns were observed. Contrast dispersion zone was not significantly associated with subgroup differences in neck pain, arm pain, or NDI-5 scores (P>0.05).CONCLUSIONImprovements in pain and function 1 month after treatment with CTFESI did not differ significantly based on the contrast dispersion pattern. Future study is needed to confirm or refute these findings in other procedural settings, in broader patient populations, and with longer-term outcome assessment.

Abstract Background and Objectives The novel coronavirus outbreak (SARS-CoV-2) began in late 2019 and dramatically impacted health care systems. This study aimed to describe the impact of the early phase of the pandemic on physician decision-making, practice patterns, and mental health. Methods An anonymous survey was distributed to physician members of the Spine Intervention Society (SIS) on March 24 and April 7, 2020. Respondents provided information regarding changes in clinical volume, treatment, and mental health (Patient Health Questionnaire [PHQ-4]) before April 10, 2020. Results Of the 1,430 individuals who opened the survey, 260 completed it (18.2%). Overall clinical and procedural volume decreased to 69.6% and 13.0% of prepandemic volume, respectively. Mean in-person clinic visits were reduced to 17.7% of total prepandemic clinic volume. Ongoing clinical visits were predominantly completed via telemedicine (video) or telephone (74.5%), rather than in-person (25.5%). Telemedicine and telephone visits represented 24.6% and 27.3% of prepandemic clinical volume, respectively. Respondents decreased in-person visits of select groups of high-risk patients by 85.8–94.6%. Significantly more providers reported increasing rather than decreasing prescriptions of the following medications: opioids (28.8% vs 6.2% of providers, P < 0.001), muscle relaxants (22.3% vs 5.4%, P < 0.001), neuropathic pain medications (29.6% vs 3.8%, P < 0.001), and acetaminophen (26.2% vs 4.2%, P < 0.001). Respondents’ mean PHQ-4 score was 3.1, with 19% reporting moderate or severe psychological distress. Several demographic factors were significantly associated with practice changes. Conclusions The novel coronavirus pandemic dramatically altered the practice and prescribing patterns of interventional pain physicians.