More Frequent Empathic Communication by Physical Therapists Is Associated With Improved Outcomes for Low-Impact Chronic Pain.

It is an observational study, so it shows association and not cause. The authors say so directly, and note that therapists who communicate differently may also treat differently. Only 31 patients and 8 physical therapists at a single clinic chosen for convenience, which limits how far the results travel. 14 of the 45 patients who enrolled completed only one assessment and were left out of the analysis, even though they looked similar at baseline. The patients who finished had mild pain, low pain interference and no mood disorders, and were mostly White, educated and married, which is not typical of people with high-impact chronic pain. Only what was said was recorded. Facial expression, listening behaviour and therapeutic touch were not captured. Not every treatment visit was recorded, and the manual coding was too labour intensive to cover them all. The analyses were exploratory with no power calculation and several outcomes tested, so some findings could be chance. The overall improvement across six weeks of rehabilitation was small and did not reach the threshold for clinically meaningful change.

Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institutes of Health. The authors state the funder played no role in the design, conduct or reporting of the study.

Do not read this as proof that empathic communication causes pain to improve. It is an observational study of 31 patients and 8 therapists in one clinic, and the authors state plainly that the associations should not be interpreted as causal, partly because therapists' treatment choices probably varied alongside their communication style.