Impact of Patient-Clinician Relationships on Pain and Objective Functional Measures for Individuals with Chronic Low Back Pain: An Experimental Study

Purpose. To compare the effects of enhanced and limited patient-clinician relationships during patient history taking on objective functional measures and pain appraisals for individuals with chronic low back pain (CLBP). Methods. Fifty-two (52) participants with CLBP, unaware of the two groups, were randomized using concealed allocation to an enhanced (n=26) or limited (n=26) patient-clinician relationship condition. Participants shared their history of CLBP with a clinician who enacted either enhanced or limited communication strategies. Fingertip-to-floor, one-minute lift, and Biering-Sorensen tests, and visual analogue scale for pain at rest were assessed before and after the patient-clinician relationship conditions. Findings. The enhanced condition resulted in significantly greater improvements in the one-minute lift test (F(1,49)=7.47, p<.01, η_p2 =0.13) and pain at rest (F(1,46)=4.63, p=.04, η_p2 =0.09), but not the fingertip-to-floor or Biering-Sorensen tests, compared with the limited group. Conclusions. Even without physical treatment, differences in patient-clinician relationships acutely affected lifting performance and pain among individuals with CLBP.