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.