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| Does your expectation of recovery following an injury help predict your actual outcome? |
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by Kory Zimney, PT - May 5, 2011
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Actually they might! Myers(1) and colleagues in 2007 did an interesting study looking at this and found, that what you think your recovery will be is a good predictor of what it actually will be. Why and how does this happen? We do not actually know, yet different theories are possible:
1. You are a very good predictor of your actual injury and your outcome.
2. Your own bias. Whatever you reported initially you will want to be self-consistent later when asked on your improvement, even if you have not improved that much.
3. If you have a higher expectation, you might be more likely to follow through with the prescribed treatment and return to regular activities.
4. The expectation itself being therapeutic, akin the placebo effects.
The last possibility is often in popular culture thought to be just “crazy fake psychological stuff”. But current neuroscience research shows this phenomenon is a normal neurobiological function of the brain and not fake at all. Our brains have an amazing ability to either up or down regulate everything we experience and do. That is why we hear of stories of wartime soldiers being significantly harmed and feel no pain. His or her brain can down regulate the pain info coming in up to 40 times more powerful than any medication we can give them. While this is an extreme example, realize your brain is always doing this to some degree. Your brain has the neurobiological ability to control information coming in and it’s response to that info. This is very real and at work with many conditions and treatments even though you don’t realize it. There is also an opposite phenomenon, if your expectation is for a negative outcome it may lead to worse symptoms.
So just expecting to get better means you will get better faster, not exactly. If you have doubts, or there are significant biological deficits, you cannot fool yourself or pretend that your expectations will get you better. So if you have doubts about your predicted outcome, seek medical advice. Research at this time cannot fully clarify if changing these expectations based on sound clinical advice leads to better outcomes, but some early research suggests this might help. So isn’t this the popular belief held by some that all you need is “mind over matter”, no. But the biological matter in your brain does matter. Bottom line, if your expectation is to get better, it probably will help. If you do not have a positive expectation, you want to seek the advice of a medical professional to help give advice to clarify expectations of your injury.
1. Myers SS, et al. Patient Expectations as Predictors of Outcome In Patients with Acute Low Back Pain. J Gen Intern Med. 2007; 23(2): 148–53.
 Kory Zimney is a practicing physical therapist in Iowa. He focuses on helping people move forward with their health and function through movement and exercise. This and other articles by Kory can be found at his blog: http://koryzimney.blogspot.com/
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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