Expectations to treatment outcome in patients with neck- and back pain regarding improvement in pain and function. A cross sectional pilot study.

Abstract

ABSTRACT Literature suggests that patients pre-treatment expectations can be clinically important for several reasons. Most interestingly has it been proposed influencing both prognoses and outcome. Expectations might therefore provide an intervention opportunity, and could perhaps be regarded as a prognostic tool. It is primarily necessary to investigate what is actually expected, to eventually explore these possible benefits. This study will look into neck/back patients expectations for treatment outcomes (pain and functional improvement) prior to their first meetings with specialists in physical medicine and rehabilitation (PMR). This study is a cross-sectional pilot study. Questionnaires were completed by patients prior to an appointment with a PMR specialist. Included patients were patients with neck/back pain and/or functional problems, referred for the first time to a PMR specialist. The forms consisted of one validated part (PSOE), and one self-constructed part with six 11-point numeric rating scales (11-NRS). Eligible patients were randomly selected between January and June 2012 at the PMR Neck/Back Outpatient Clinic, Oslo University Hospital. Approximately 42 % of the patients expected their status to remain un-changed. A total of 17 % expected exacerbation of their status. No differences were found between expectations regarding pain and function. The patients did not expect full recovery. Highly educated patients, and those reporting high usage of analgesics, expected to improve more in pain and function. More elaborate studies are needed to confirm these results. These results are, to our opinion, surprisingly low, too pessimistic for this patients group. If the suggested results are trustworthy should one take notice in the potential relation between negative expectations and outcome.