The effects of patient-provider communication on 3-month recovery from acute low back pain

Background: patient-provider communication has been indicated as a key factor in early recovery from acute low back pain (lbp),one of the most common maladies seen in primary care; however,associations between communication and lbp outcomes have not been studied prospectively. methods: working adults (n = 97; 64% men; median age,38 years) with acute lbp completed baseline surveys,agreed to audio recording of provider visits,and were followed for 3 months. using the roter interaction analysis system,10 composite indices of communication were compared with 1- and 3-month patient outcomes. results: patients (n = 30) with significant pain and dysfunction persisting at 3 months provided more biomedical information (t[75],2.61; p < .05) and engaged in more negative rapport building (t[75],2.33; p < .05) but showed no increase in psychosocial/lifestyle communication during the initial visit (p > .05). providers asked these patients more biomedical questions (r = 0.35 with dysfunction),more psychosocial/lifestyle questions (r = 0.30),made more efforts to engage the patient (t[75],4.49; p < .05),and did more positive rapport building (t[75],2.13; p < .05). conclusions: providers adapt their communication patterns to collect more information and establish greater rapport with high-risk patients,but patients focus more on biomedical than coping concerns. to better elicit psychosocial concerns from patients,providers may need to administer brief self-report measures or adopt more structured interviewing techniques.