I always try to look for ways to improve treatment outcomes for my patients. Whether that means learning new treatment techniques, experimenting with new exercises, delving into medical history and other contributing factors, or helping them set alarms on their phones to remind them to do their HEP. One important factor when aiming for better treatment outcomes is whether the patient expects to improve in response to treatment.
It’s a common idea that if you start something with the belief that it’s not going to work for you, there’s a pretty good chance that it won’t. This would suggest that if you start off believing that same thing WILL work for you, there’s a better chance of it working. Researchers in Sweden put this idea to the test in an article published in 2019 in the European Journal of Pain (found here). They followed 593 patients with low back pain, and found that patients with a high expectation of improvement after their first visit were 58% more likely to report improvement at visit four. These findings were independent of variations in baseline pain intensity, psychological profile, and self-rated health.
I love reading about studies like this, because I think there is so much more to healing than the physical acts of soft tissue and joint mobilizations, stretching, and strengthening exercises. Beliefs about what Physical Therapy can and cannot do, prior experience with PT (whether good or bad), past experiences with chronic pain and/or pain that resolves on its own; all of these things, and many more, play a huge role in healing, well-being, and overall return to function. I will certainly be putting more emphasis on improving my patients’ expectations during my initial evaluations, and perhaps findings like these will have you doing the same.
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