Negative language use of the physiotherapist in low back pain education impacts anxiety and illness beliefs: a randomised controlled trial in healthy respondents

Review written by Dr Jarod Hall info

Key Points

  1. Negative health and injury related communication influences state anxiety and illness beliefs in the recipient of the message.
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BACKGROUND & OBJECTIVE

Verbal communication in physiotherapy is an important dimension of the patient-therapist relationship and has been identified as one of the contextual factors responsible for the non-specific treatment effect in physiotherapy (1-4). These contextual factors (e.g. words, behaviors, graphics, etc.) can have an impact on patient illness beliefs. Illness beliefs refer to patients’ lay perceptions and cognitions about a condition and its possible threats. Such lay beliefs include anticipated future outcomes and expectancies. These patient expectancies can have an important role in the molecular and neural network changes underlying placebo and nocebo effects.

This study aimed to determine the effect of physiotherapists’ negative language use on nocebo effects of state anxiety and illness beliefs. The authors hypothesized that the experimental condition (more “nocebic” language and explanations) would evoke more anxiety and more negative illness beliefs compared to the control condition.

Verbal communication in physiotherapy has been identified as one of the contextual factors responsible for the non-specific treatment effect in physiotherapy.
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A very limited interaction between the patient and therapist can induce negative expectations about LBP, even in people without current back pain.

METHODS

  • This study was designed and conducted as a balanced (1:1) simple randomization, double blind, controlled, parallel group study conducted online in the Netherlands.
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