Spine Journal - 2026-07-16 - Journal Article
Beyond Clinical Outcomes: A Reddit Analysis of Patient Sentiment and Experiences with Sacroiliac Joint Dysfunction and Fusion.
Hulse HB, Arhewoh R, Khan MT, Rotramel NA, Patel R, Aleem I, Piche JD
Topics
Key Takeaway
Among 1,553 Reddit posts on SI joint dysfunction, surgery and pain management categories showed the highest negative sentiment (24.7% and 25.8%, respectively), suggesting a gap between published PROMs and real-world patient satisfaction.
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Summary
This study analyzed 10 years (2014–2024) of Reddit posts to characterize patient sentiment and thematic concerns surrounding SI joint dysfunction and fusion using NLP-based sentiment classification. Of 1,553 qualifying posts, 81.0% were positive/neutral and 19.0% negative overall, but surgery-related and pain management posts carried disproportionately higher negative sentiment at 24.7% and 25.8%. Post volume grew at a 129% compound annual growth rate from 2020–2024, with longer posts independently associated with negative sentiment (36.5% vs. medium-length posts).
Key Limitation
NLP sentiment classification cannot distinguish between a patient expressing negative sentiment about their own outcome versus negative sentiment directed at the healthcare system, insurance barriers, or diagnostic delays, limiting the clinical specificity of the findings.
Original Abstract
BACKGROUND CONTEXT
Sacroiliac (SI) joint dysfunction is a common cause of chronic low back and buttock pain, with SI joint fusion serving as a surgical intervention for patients who fail conservative management. While clinical studies provide patient-reported outcome measures (PROMs), real-world patient experiences, satisfaction, and complications remain underreported. Social media platforms are a vast database of patient narratives, and Reddit offers patients an anonymous support network.
PURPOSE
To analyze sentiment and thematic trends in Reddit posts related to SI joint dysfunction and how patients engage with online communities to share experiences, navigate treatment decisions, and express concerns not captured by traditional outcome measures.
STUDY DESIGN/SETTING
Retrospective, cross-sectional, mixed-methods study utilizing approximately 75,000 Reddit posts (2014-2024) across medical and patient-centered forums.
PATIENT SAMPLE
1,553 Reddit posts meeting inclusion criteria, identified from approximately 75,000 screened posts containing SI joint dysfunction-related keywords across the 10-year study period.
OUTCOME MEASURES
Sentiment classification (positive/neutral vs. negative) assessed via natural language processing, thematic categorization of posts, longitudinal trends in post volume, and associations between post characteristics and sentiment.
METHODS
Posts containing SI joint dysfunction-related keywords were identified and classified into four groups: surgery and related discussion, pain management, physical therapy and rehabilitation, and general discussion. Sentiment was assessed using natural language processing. Post characteristics such as length, date, and engagement metrics were also collected.
RESULTS
General discussion comprised 41.5% of posts, followed by pain management (21.7%), physical therapy and rehabilitation (19.1%), and surgery-related discussion (17.7%). Sentiment analysis classified 81.0% of posts as positive/neutral and 19.0% as negative. Surgery (24.7%) and pain management (25.8%) posts showed significantly higher negative sentiment, often reflecting frustration or unmet expectations. Longer posts showed significantly higher negative sentiment (36.5%) compared to medium-length posts. From 2020 to 2024, post volume rose substantially with a compound annual growth rate of 129%, reaching 749 new posts in 2024.
CONCLUSIONS
To our knowledge, this is the first study to use social media to analyze real-world experiences of patients with SI joint dysfunction and those undergoing SI joint fusion. There is a meaningful portion of online discussion which express negative sentiment particularly in the surgery-related and pain management category. This highlights a potential gap between published outcomes and unmet patient expectation and provides an avenue for targeted intervention and further studies.
LEVEL OF EVIDENCE
IV.