1007 - The Influence of Expectations in Chronic Pain Treatment Outcomes

We conducted a prospective cohort study at Albany Med Comprehensive Spine and Pain Center, enrolling adult patients (≥18 years old) with confirmed diagnosis of MPS or Sacroiliitis for ≥ 3 months. Exclusion criteria included pregnancy, fibromyalgia, adverse reactions to local anesthetics, and significant bleeding disorders. Patients completed baseline assessments using the Stanford Expectations of Treatment Scale (SETS) to gauge pre-treatment expectations and the PROMIS-29 to evaluate physical function, sleep disturbance, pain interference, and social participation. Pain intensity was assessed using the Numeric Rating Scale (NRS). Follow-up assessments were performed two weeks post-treatment to measure changes in pain intensity and function.

Results: 44 patients completed all study procedures, including 35 females and 9 males. The correlation between pretreatment SETS scores and change in pain was not statistically significant (Spearman’s ρ = 0.088, p = 0.571).  Pain intensity showed a significant difference (T statistic = 5.934, p < 0.001) between initial pain scores and 2-week follow up. From the PROMIS-29, average sleep disturbance (T = 2.641, p = 0.0114), pain interference (T = 4.803, p < 0.001), and physical function (T = -3.117 p = 0.0033) all showed significant difference between initial scores and 2-week follow up.

Conclusions: Although pain intensity and functional outcomes improved significantly after treatment, pretreatment pain expectations were not significantly associated with change in pain from baseline to followup. This may suggest a multimodel therapeutic benefit from injections and need for additional research exploring the role of patient expectations in managing pain.