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

UMMS Affiliation

Department of Family Medicine and Community Health

Publication Date


Document Type



Acute Disease; Adult; *Communication; Disability Evaluation; Female; Health Care Surveys; Health Status Indicators; Humans; Low Back Pain; Male; Middle Aged; Pain Measurement; Patient-Centered Care; *Physician-Patient Relations; Primary Health Care; Prognosis; Prospective Studies; Psychometrics; Questionnaires; Risk Assessment; Statistics as Topic; Tape Recording; Time Factors; Treatment Outcome


Community Health and Preventive Medicine | Preventive Medicine | Primary Care


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.

DOI of Published Version



J Am Board Fam Med. 2011 Jan-Feb;24(1):16-25. Link to article on publisher's site

Journal/Book/Conference Title

Journal of the American Board of Family Medicine : JABFM

Related Resources

Link to Article in PubMed

PubMed ID