Study examines how patient expectations relate to health factors in lumbar spinal stenosis

In a recent study, researchers studied how physical and mental health factors relate to each other in people with lumbar spinal stenosis (LSS), a condition that narrows the lower spine.

Lead author Adam Babitts, DPT, a PhD candidate in rehabilitation science, worked with Professor Dawn M. Ehde, PhD; Professor Janna L. Friedly, MD, MPH; Professor Pradeep Suri, MD, MSc; and Associate Professor Sean D. Rundell, PT, DPT, PhD from the Department of Rehabilitation Medicine at the UW School of Medicine, along with colleagues from other institutions.

The team analyzed baseline data from 598 patients treated at Duke University and University of Washington spine clinics between 2021 and 2024. They examined whether relationships among physical and mental health factors differed based on patients’ expectations for recovery.

Patients rated their recovery expectations on a 0–10 scale. Researchers compared two groups: low expectations (226 participants) and high expectations (108 participants). Participants with mid-range scores were not included in this comparison.

The team used network analysis to examine how factors such as pain interference, physical function, social participation, fatigue, anxiety, depression, cognition, sleep disturbance, and symptom duration relate to each other.

Symptom duration was not strongly associated with other factors in either group. Pain interference and fatigue were the most influential factors in both groups. Anxiety played a stronger role among patients with low recovery expectations than among those with high expectations.

The study was published April 24, 2026, in Pain Medicine.