For years, we've heard that psychological factors may profoundly affect the results of treatment for an illness. Consider the stories of "miracle cures" by terminal cancer patients who kept their spirits up and maintained that "never say die" attitude throughout treatment.

A recent study in the journal Spine suggests that pessimistic thinkers may have trouble recovering from low back pain.

The authors examined the relationship between patient expectations of treatment benefits and treatment outcomes. One hundred thirty-five patients with chronic LBP were divided into either a massage or an acupuncture treatment group. Prior to the study, patients rated how helpful they expected their treatment to be on a scale from 0-10 (10 being extremely helpful). Following 10 weeks of treatment, the functional ability of each patient was determined using a disability scale.

Participants with higher expectations for their treatment experienced less pain in 86 % of cases, while patients with low expectations only improved in 68 % of cases. Odds of improvement were five times greater for the high-expectation group than the low-expectation group after adjusting for other factors, such as physical health, age, education, etc. Patients who expected benefit from one treatment, as opposed to the other, improved more from that particular treatment.

Don't let an illness or health concern get you down! As this evidence suggests, attitude may influence your recovery as much as the actual treatment you receive. Try to be optimistic the next time you receive treatment for any illness, and talk to your doctor about the best way to stay healthy and happy for a lifetime.


Kalauokalani D, Cherkin DC, Sherman KJ, et al. Lessons from a trial of acupuncture and massage for low back pain: Patient expectations and treatment effects. Spine, July 1, 2001:26(13), pp. 1418-1424.

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