[RESEARCH] What Back Pain Patients Want and the Assumptions Medical Doctors Have | Modern Manual Therapy Blog - Manual Therapy, Videos, Neurodynamics, Podcasts, Research Reviews

[RESEARCH] What Back Pain Patients Want and the Assumptions Medical Doctors Have

[RESEARCH] What Back Pain Patients Want and the Assumptions Medical Doctors Have - themanualtherapist.com

Goal of the Study?

In this prospective clinical study, researchers asked low back pain subjects: what is important to them? 1 This was to help reveal what patients want with care rather than the assumptions that clinicians have about the clinical encounter.


Why are they doing this study?

The study’s primary purpose was to evaluate and understand more clearly the expectations low back pain patients have about the care they receive to lead to better outcomes ultimately. Previous studies have shown that therapy does not always depend on a precise diagnosis and can often deteriorate the doctor-patient relationship. 2


What was done?

This prospective clinical study used surveys at two multidisciplinary university specialty spine clinics. After obtaining consent and the demographics of the participants, they were asked “what is important to you?” and several ( variables) were offered and asked to rank (0-4) the importance of each variable. 



  • improvement in pain
  • improvement in function
  • explanation of what is causing their pain
  • thorough exam
  • diagnostic testing
  • medication
  • physical therapy
  • surgery


What did they find?

Interestingly, physicians’ assumptions did not match what the participants wanted. Doctors appear to put significant emphasis on arriving at a diagnosis whereas low back patients wanted: 


Top Three Variables Important to the Patient by a Significant Margin

  1. improvement in pain
  2. improvement in function
  3. an explanation of what is causing their pain


Bottom Four Variables (Less Important to the Patient)

  1. diagnostics
  2. medication
  3. physical Therapy
  4. surgery


Why do these findings matter?

What a patient wants should match what a physician delivers when caring for people with back pain. When a mismatch occurs between what physicians assume vs. a patient’s expectations, disruption in the therapeutic alliance can likely happen. 


At Dynamic Disc Designs, we have worked to provide physicians, chiropractors, osteopaths and physical therapists dynamic, realistic models to help in the explanation of what is causing low back pain. In this study, one can see the importance of understanding the cause of one’s symptoms from a patient’s perspective.


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