Patient expectations assessed before randomisation and after the first treatment session, and their associations with pain outcome at 3 months in patients with tennis elbow: a secondary analysis of a randomised controlled feasibility trial in Norwegian secondary care.
BMJ OpenSep 15, 2026 (epub)
Clinical ResearchPhysical Medicine & Rehabilitation
Håkon Sveinall, Cecille Røe, Kaia B Engebretsen et al.
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In 30 seconds
This secondary analysis of a randomized controlled trial evaluated the relationship between patient expectations of pain improvement before and after the first treatment session in adults with tennis elbow. The study found that expectations at the second time point were positively associated with pain outcomes at three months, with a regression coefficient of b=0.61 (95% CI 0.33 to 0.89, p<0.01).
Key findings
- In the shock wave group, 47% of participants expected greater improvement after the first treatment.
- In the advice group, 41% of participants expected less improvement after the first treatment.
- Expectations at T 2 were positively associated with pain at T 3 (b=0.61, 95% CI 0.33 to 0.89, p<0.01).
- Adding education and baseline pain increased explained variance from R 2 =0.27 to R 2 =0.32.
Why it matters
Understanding the role of patient expectations in pain outcomes can help clinicians tailor treatment approaches and improve patient engagement, potentially enhancing recovery in musculoskeletal conditions.