Patient expectations and therapist perceptions in low back pain care: A cross-sectional survey

Musculoskelet Sci Pract. 2026 Mar 18;83:103547. doi: 10.1016/j.msksp.2026.103547. Online ahead of print.

ABSTRACT

BACKGROUND: Low back pain is one of the most common conditions managed by physical therapists. Positive patient expectations have been associated with improved clinical outcomes; however, limited research has examined how physical therapists perceive patients' expectations at the initial consultation.

OBJECTIVE: To explore patients' expectations at their initial physical therapy evaluation and compare them with physical therapists' perceptions of those expectations.

METHODS: A cross-sectional survey was conducted at a large medical center in the United States. Patients and physical therapists completed an identical 10-question, 5-point Likert scale assessing expectations for initial care. Patients completed the survey prior to their first visit; therapists responded electronically. Mann-Whitney U tests were used to compare group differences.

RESULTS: 144 patients and 22 physical therapists completed the survey. Patients most frequently rated provision of a home exercise program as "very" or "extremely important" (93%). Physical therapists assigned relatively greater importance to examination, diagnosis, and prognosis. Statistically significant differences (Bonferroni-adjusted p ≤ 0.001) reflected differing emphases between groups.

CONCLUSION: Patients and physical therapists assigned varying levels of importance to several components of initial low back pain care. Physical therapists tended to place relatively greater importance on examination-related elements, whereas patients emphasized receiving a home exercise program. These findings suggest that patient priorities and therapist perceptions may not always align during initial consultations. Therapists may consider directly asking patients about their expectations during the initial consultation to clarify what individuals hope to gain from the clinical encounter.

PMID:41864181 | DOI:10.1016/j.msksp.2026.103547