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

William S. Shaw, Glenn Pransky, Debra L. Roter, Thomas Winters, Torill H. Tveito, Susan M. Larson

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)16-25
Number of pages10
JournalJournal of the American Board of Family Medicine
Issue number1
StatePublished - Jan 2011


  • Back pain
  • Communication
  • Patient-centered care
  • Patient-provider communication
  • Prognosis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Family Practice


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