Prior therapeutic experiences and treatment expectations are differentially associated with pain-related disability in individuals with chronic pain

Many individuals suffering from chronic pain do not benefit sufficiently from treatment. Prior treatment experiences and treatment expectations play a significant role in perceived symptom severity and treatment-related outcomes in many chronic diseases. Their role in chronic pain, however, remains underexplored. Therefore, the present study investigated the role of treatment experiences and treatment expectations for pain-related disability in individuals suffering from chronic pain. Participants suffering from chronic pain who were receiving treatment (pharmacotherapy, physiotherapy, and/or psychotherapy) completed questionnaires as part of an online survey. Prior improvement, worsening, and side effect experiences and their relation with treatment expectations were assessed with the generic rating scale for previous treatment experiences, treatment expectations, and treatment effects (GEEE), and pain-related disability via the pain disability questionnaire (PDI). Multiple linear regressions were performed to determine how prior treatment experiences related to treatment expectations and whether prior experiences and current treatment expectations were associated with pain-related disability. In total, 212 participants (86.3% female) were included. Prior worsening experience as well as stronger worsening and side effect expectations were associated with higher pain-related disability. Screening patients for different expectation domains could be an important strategy to detect and target potentially relevant factors influencing pain-related disability and treatment outcome.