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Lippincott Williams & Wilkins

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FOR IMMEDIATE RELEASE

PATIENT EXPECTATIONS AFFECT RESULTS OF ALTERNATIVE THERAPIES FOR BACK PAIN

PHILADELPHIA, PA July 6, 2001 - At least some of the benefits of alternative medicine treatments for low back pain may be related to the patient's expectation that the treatment will work, according to a study in the July 1 issue of the journal Spine.

In a study of 135 patients with low back pain who were randomly assigned to acupuncture or massage therapy, those who expected good results were more likely to improve after treatment, writes a research team led by Dr. Donna Kalauokalani of Washington University, St. Louis.

Eighty-six percent of patients with high expectations had "clinically significant" improvement, compared to 68 percent of those with low expectations. The effects of expectations were treatment specific--for example, patients with stronger expectations for massage therapy had greater improvement if they received that treatment.

After adjustment for other factors, patients with high expectations were five times more likely to improve after massage therapy or acupuncture.

Low back pain is a very common problem, and one in which psychological factors may affect the response to treatment. It is also one of the leading reasons why patients seek alternative medicine therapies.

The new results suggest that patient expectations have an important impact on the results of treatment--particularly when they expect that a specific treatment may be helpful.Dr. Kalauokalani and colleagues believe their results have implications for both research and treatment. In research, adjusting for patient expectations may be important in assessing the true success of a given treatment, whether conventional or alternative. In treatment, expectations could affect the choice of therapy for an individual patient. The researchers write, "the current findings support shared decision making by patients and providers as a basis for improving clinical outcomes, particularly when the safety and costs of each treatment are similar."Recognized internationally as the leading journal in its field, Spine reports on today's most important diagnostic and therapeutic advances regarding spinal pain, deformity, and disability. Distinguished by its broad scope of coverage and emphasis on patient care, this popular biweekly has earned must-read status in the orthopaedic community. For more information, call 1-800-638-3030 or visit