To evaluate the relationships between patient and physician pretreatment expectations of pain
relief and subsequent pain
relief reported by chronic pain
patients immediately after treatment.
Prospective study of consecutive patients undergoing a procedure in a pain
clinic for treatment of chronic pain
. Patients rated their current pain
level and their expectation of pain
relief immediately prior to undergoing a procedure (e.g., intravenous drug infusion, nerve block) for the treatment of chronic pain
. Simultaneously and independently, the treating physician completed a similar questionnaire. At completion of the procedure, patients rated their current pain
level and degree of pain
University of Washington Multidisciplinary Pain
Center procedure suite.
Forty-six consecutive chronic pain
Intravenous drug infusions and nerve blocks.
relief expectation ratings were not correlated significantly with their postprocedure pain
relief ratings or pre-post procedure changes in pain
ratings. However, a statistically significant correlation was found between physician expectations of pain
relief and patient pain
relief ratings and patient pre-post procedure changes in pain
The results of this study suggest that physicians are better predictors than are patients of patient responses to these procedures and/or that physicians may somehow subtly communicate their expectations to patients during the procedure, and these expectations then influence patient response. Patient pretreatment expectations may not always play a significant role in nonspecific treatment effects.