I overheard the physical therapists at our hospital saying they can tell which back and neck patients will get better and who won't. Is this really possible?

Research is uncovering more and more ways to predict who will improve with treatment.This is true for a wide range of medical or health problems. These are called predictive factors of outcome.

In the case of chronic pain affecting the back and/or neck, several predictive factors have been identified. Having both back AND neck pain present at the same time is the first prognostic indicator. These patients are less likely to improve or get better compared to patients who only have neck OR back pain.

Older age (65 years or older) and a previous history of neck or back pain are also included as negative predictive factors. In other words, the presence of either of these is linked with a poor outcome.

Patients who have low expectations of treatment or who do not think they will ever get better often don't improve. And a recent study from England confirmed that physical therapists are in fact aware of these types of psychosocial factors being strongly linked with poor treatment results.

Jonathan C. Hill, MSc, et al. Predictors of Poor Outcome in Patients with Neck Pain Treated by Physical Therapy. In The Clinical Journal of Pain. October 2007. Vol. 23. No. 8. Pp. 683-690.

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