Treatment Expectations & Pain Relief
Healthcare expectations are defined as a belief that some clinical outcome will result. Research has demonstrated that expectations can be extremely influential in terms of their ability to reduce pain and speed recovery. In fact, expectations are often thought to be equally, if not more, important than the actual intervention being delivered.
As an example of how powerful our beliefs can be, we can look at research on the placebo effect. There are 2️⃣ types of these studies and their designs dramatically alter symptom responses.
💊In the traditional placebo-controlled study, the individual hears the following message, “you will be randomly assigned to receive either the studied intervention or the placebo", which means they know they have a 50% chance of receiving the placebo.
💊In the second study design, where placebo mechanisms are under investigation, subjects are told, “the agent you have just been given is known to significantly reduce pain in some patients" when really some of the subjects are actually receiving the placebo.
The second design was demonstrated beautifully in a study by Bausell et al in which investigators compared acupuncture with sham acupuncture for the treatment of post-procedural dental pain and observed outcomes were dependent not upon the intervention the subject actually received, but upon the intervention the participant thought he or she had received. Subjects receiving the acupuncture who believed they received the sham acupuncture did not do as well as those who received the sham acupuncture and who believed they had received actual acupuncture.
As healthcare providers, this is a good reminder that we must continually strive to better understand the attitudes and beliefs of our patients. Otherwise, our well-intended interventions may have little or no effect because we spent more time thinking about which treatment 'tool' will be best instead of working to better understand the person.
📚Bialosky JE et al. Individual Expectation: An Overlooked, but Pertinent, Factor in the Treatment of Individuals Experiencing Musculoske