Treatment Expectancy for Chronic Pain Affects the Outcome

Patients' initial beliefs about the success of a given pain treatment are shown to have an important influence on the final treatment outcome. This study used the data from two randomized clinical trials evaluating the effectiveness of cognitive-behavioral interventions for 171 patients with fibromyalgia and chronic low back pain. Treatment expectancy was measured by a short questionnaire. Four outcome variables were measured before and after the intervention and a 12 months follow-up (pain coping and control, motor behavior, negative affect, and quality of life). Patients with higher treatment expectancies significantly received less disability compensation and were less fearful. Pre-treatment expectancy significantly predicted each of the 4 outcome measures immediately after treatment and at 12 months follow-up. This study corroborates the importance of treatment expectation before entering a cognitive-behavioral intervention in patients with chronic musculoskeletal pain. Goosens ME, et al. Clinical Journal of Pain. 21(1):18-26; discussion 69-72, 2005 Jan-Feb.