Understanding Patient Perspectives in Spine Care: A Social Media Analysis of 2,513 Posts Reveals Distinct Patterns in Treatment Perceptions

Introduction: This study explored patient perceptions and attitudes toward common symptoms and interventions in spine care using data from large online communities. Understanding these patterns is crucial as patients increasingly turn to social media platforms for health information and support.

Methods: Posts from spine-related subreddits (r/backpain, r/spinalcordinjury, r/orthopaedics) were extracted using the Python Reddit API Wrapper (PRAW). Data extraction was guided by 39 predefined keywords covering symptoms (n=8), interventions (n=25), and risk factors (n=6). Natural language processing techniques, including sentiment analysis, were employed to assess relationships between symptoms, interventions, and patient sentiment. Clustering and temporal analyses identified key trends in patient discussions.

Results: Analysis of 2,513 posts revealed pain as the predominant symptom (74.1%, n=1,862), followed by numbness (11.1%, n=280) and sciatica (9.7%, n=245). Multiple symptoms were reported in 31.2% of symptomatic posts. Physical therapy was the most discussed intervention (10.8%, n=272), followed by medication (5.6%, n=140) and microdiscectomy (3.9%, n=99). Significant associations emerged between numbness and surgical interventions (microdiscectomy: X²=14.37, p=0.014; spinal fusion: X²=11.94, p=0.026). Sentiment analysis revealed modest but positive scores for most interventions, with numbness-microdiscectomy showing the highest positive sentiment (0.066 [0.008, 0.125]). Statistical analysis revealed non-normal distributions in pain-related intervention sentiments, suggesting more polarized patient experiences, while numbness-related discussions showed normal distributions, indicating more predictable responses. The five identified clusters showed distinct characteristics: Sciatica-Medication (mean sentiment=0.024, SD=0.134), Pain-Medication (0.048, SD=0.119), Numbness-Physical Therapy (0.007, SD=0.134), Pain-Physical Therapy (0.057, SD=0.138), and Numbness-Microdiscectomy (0.038, SD=0.113). Age dominated risk factor discussions (97.6% of mentions), suggesting limited awareness of modifiable risk factors. Temporal analysis showed a marked increase in discussion volume after 2022, particularly regarding pain-related topics.

Conclusion : Our findings highlight how social media analysis can reveal distinct patterns in patient experiences with regards to spine care. Variable sentiment towards the identified interventions and symptoms combined with the notable lack of discussion around modifiable risk factors suggests opportunities to enhance preoperative counseling and expectation management. By understanding these sentiment patterns, clinicians can better tailor their approach to patient education and intervention selection, ultimately strengthening the therapeutic alliance in spine care.