Expectations about the benefit of exercise, not surgery, are associated with future pain and physical function in patients with non-specific low back pain

Review written by Dr Jarod Hall info

Key Points

  1. Patients with high expectations that exercise would help their low back pain experienced significantly better outcomes in both pain interference and physical function at six weeks and six months.
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BACKGROUND AND OBJECTIVE

Patient expectations are shaped by interactions with healthcare professionals and the broader healthcare system and can significantly affect satisfaction and treatment outcomes (1). The extent to which these expectations are met often dictate patient satisfaction (2). In the context of low back pain (LBP), a globally prevalent condition with persistently modest long-term outcomes, psychosocial factors like beliefs and expectations are increasingly recognized as key influences. Despite medical advances, outcomes for LBP have changed very little over the last several decades, likely due to the heterogenous nature of this condition (3,4).

The aim of this study was to assess the association of expectations about surgery and exercise interventions and longitudinal outcomes in a cohort of patients receiving nonpharmacologic care for LBP.

Patient expectations are shaped by interactions with healthcare professionals and the broader healthcare system and can significantly affect satisfaction and treatment outcomes.
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Educating patients about the benefits of exercise and addressing misconceptions or fears may not only improve engagement but also enhance the overall effectiveness of non-surgical treatment plans.

METHODS

This was a secondary analysis using a prospective cohort of 629 participants derived from three different randomized clinical trials (RCTs). The RCTs used are three trials on non-pharmacologic LBP treatments conducted in the U.S. Military Health System across four hospitals

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