Home > Journals > European Journal of Physical and Rehabilitation Medicine > Past Issues > European Journal of Physical and Rehabilitation Medicine 2017 December;53(6) > European Journal of Physical and Rehabilitation Medicine 2017 December;53(6):936-43



To subscribe
Submit an article
Recommend to your librarian


Publication history
Cite this article as



European Journal of Physical and Rehabilitation Medicine 2017 December;53(6):936-43

DOI: 10.23736/S1973-9087.17.04608-1


language: English

The influence of expectations on improvements in pain and function in patients with neck/back/shoulder complaints: a cohort study

Sigrid SKATTEBOE 1, 2 , Cecilie RØE 1, 2, Morten W. FAGERLAND 3, Lars-Petter GRANAN 4

1 Deparment of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; 2 Faculty of Medicine, University of Oslo, Oslo, Norway; 3 Oslo Center for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway; 4 Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway

BACKGROUND: In musculoskeletal research, patients’ expectations have recently received increased attention. However, few prospective studies have investigated these expectations or their prognostic significance and possible clinical value.
AIM: To investigate the influence of patients’ expectations on improvements in pain and functional status six months after an outpatient physical medicine assessment.
DESIGN: Prospective cohort study.
SETTING: Physical Medicine and Rehabilitation (PMR) outpatient clinic.
POPULATION: Patients with neck, back, or shoulder complaints.
METHODS: Pain, during rest and activity, and functional status (PainFunction) were assessed using numerical rating scales (NRSs; 0 to 11) prior to a PMR consultation and after six months. At baseline, the patients were asked to define their expectations (Exp) regarding pain and functional status at six months using equivalent NRSs. The influence of Exp on PainFunction at six months was assessed through multiple regression analysis, controlling for demographic factors.
RESULTS: A total of 256 patients were included between January and June 2013, and 181 were followed up at six months. PainFunction improved statistically significant between baseline and six months (P<0.001). Approximately 40% of the patients expected (Exp) an improvement, while 29% reported an improvement at six months, reflected by a minimum of two points improvement in PainFunction. The regression analysis revealed that sick leave and the number of pain sites, but not expectations (Exp), influenced improvement in PainFunction at six months.
CONCLUSIONS: The present study does not support the suggested influence of expectations on pain and functional improvement in patients with neck, back or shoulder complaints.
CLINICAL REHABILITATION IMPACT: The patients’ expectations were more positive than their actual pain and functional improvements. However, their expectations did not significantly influence the study outcomes.

KEY WORDS: Back pain - Neck pain - Shoulder pain - Musculoskeletal pain - Treatment outcome - Physical and rehabilitation medicine

top of page