Do back patients who expect treatment to help them get better than those who don't? Many doctors, physiotherapists, and researchers think so. Scientists haven't been able to prove it yet. A new study from the University of California, Los Angeles, can shed some light on this topic.

In this study, 681 patients with low back pain were treated in one of four groups. The groups included medical care with and without physiotherapy, and chiropractic care with and without physical modalities. Modalities included heat, cold, ultrasound, and electrical muscle stimulation.

Researchers found that patients getting medical care with physiotherapy had the best results. They think this is because these patients received the most contact (31 minutes instead of 14 minutes with other treatments). The therapists told patients what to expect from the treatment. Education about back care was also included by the physiotherapists.

Patients who had back pain the longest were less likely to expect good results. On the other hand, older patients, women, and nonwhites had high levels of belief that treatment would work. This may be because these patients accept the authority of a doctor or therapist.

Are the results of all types of therapy based on patient's beliefs about what will happen? We don't know yet. This is the next step for researchers to explore.

Michael S. Goldstein, PhD, et al. The Impact of Treatment Confidence on Pain and Related Disability Among Patients With Low-Back Pain: Results From the University of California, Los Angeles, Low-Back Pain Study. In The Spine Journal. November/December 2002. Vol. 2. No. 6. Pp. 391-401.