Managing Patient Expectations

Patient expectations in health care continue to increase and this is something that needs to be managed adequately in order to improve outcomes and decrease liability. Understanding patients’ expectations can enhance their satisfaction level.

Expectations, with reference to healthcare, refer to the anticipation or the belief about what is to be encountered in a consultation or in the healthcare system. It is the mental picture that patients or the public will have of the process of interaction with the system. Patients come to a consultation with expectations that they may or may not be overtly aware of. These expectations may be openly presented or the physician may have to attempt to elicit them. Reactions to unmet expectations can range from disappointment to anger.

Some of the general expectations of patients include:

the need to be listened to
the need to receive a clear explanation about their condition
to be treated with care/concern/compassion and
to be treated by staff who are professional in their work

Some examples of unrealistic expectations of patients would include:

wanting to discuss several major problems, all in one standard consultation
prescription/ treatment/ injections to be given without a consultation
ability to call the physician 24 hours a day for any problems and
thinking that the physician will always know the exact diagnosis at the first consultation and start treatment immediately
a belief that every treatment/ intervention will work as a cure

At Pain Spa, we believe in patient-centred care

This represents a partnership between patients and their healthcare provider, where both parties are open, flexible, and respectful to each other in the provision of all aspects of care. Patient-centred care includes:

  • Respect for patient values, preferences, and expressed needs
  • Coordination and integration of care
  • Providing adequate information including clinical, management, and even prognostic information

It is important to note the following regarding treatments provided by us to help patients with their pain conditions:

  1. Treatments/ Injections may not work. Dr Krishna will explain this clearly during the consultation as well as during the consent process.
  2. Treatments/injections may help the pain to some extent but not cure it completely. In most cases, the aim of the injection treatment is to facilitate a rehabilitation process including regular exercise as this is the mainstay of management for chronic pain conditions.
  3. Individual patients respond differently to treatments, which means that some patients may get an excellent response to certain injections while others may not respond optimally to the same treatment. In simple words, just because your friend has responded well to a certain injection does not mean that you would also respond in the same way. The vice versa would also be true!
  4. Injections are not magic bullets-it is unlikely that one injection will cure all of your pain. This is especially relevant if your pain has been persistent for a long time.
  5. Some patients may need more than one treatment before they notice any improvement in their pain.
  6. Some patients may not improve in spite of trying different kinds of treatments/injections. This means that there is unlikely to be a cure for their problem and they may need to accept a level of pain and learn to live with it. Unfortunately, even in the 21st-century, we do not have answers to every single medical problem.
  7. Last but not least, paying for your treatment does not make it work any better.

Useful Patient Resources

This video is an introductory film about the diagnosis and treatment of functional neurological disorder (FND).The film has been designed to describe what FND is (particularly functional motor symptoms like paralysis and movement disorders), how its diagnosed and how treatment can help. 

Useful information on functional Neurological disorder (FND): please click the link below:

FND Resources

Non-Epileptic Attacks: This site was created by a group of healthcare professionals interested in developing effective treatments for non-epileptic attacks. Please click on the link below for further information:

Useful reading resources: please click the links below

Dopesick: Disney’s hard-hitting drama about the opioid crisis stars Michael Keaton, Peter Sarsgaard and Rosario Dawson. Exploring the epicentre of America’s struggle with opioid addiction, from the boardrooms of Purdue Pharma, to a distressed Virginia mining community and to the hallways of the DEA. Please click the link below for further details:

Body in Mind: the role of the brain in chronic pain, Professor Lorimer Moseley, Professor of Clinical Neurosciences & Chair in Physiotherapy, University of South Australia; Explain Pain and Painful Yarns: metaphors & stories to help understand the biology of pain

  • What role does the brain play in chronic and complex pain?
  • How does the brain change when pain persists?
  • Can you influence the amount of pain you feel?
  • Why does someone who has lost a limb still feel pain?
  • Can the pain be treated?
  • What are the broader implications of the research in developing better treatments for people in pain?

Please click on the following link for further details:

When it comes to pain everything matters, with Prof Lorimer Moseley

  • How do I know my pain system is over-protective?
  • What can I do to retrain my system to be less protective?
  • Am I safe to move?

Please click on the link below for further details:


Please click on the video link for further information:



Why Re-thinking Pain Really Matters:

Tame the beast: by Lorimer Moseley

Professor Lorimer Moseley is a clinical scientist investigating pain in humans. After posts at The University of Oxford, UK, and the University of Sydney, Lorimer was appointed Professor of Clinical Neuroscience and Chair in Physiotherapy at the University of South Australia. He has published over 310 papers, six books and numerous book chapters. He has given over 150 keynote or invited presentations at interdisciplinary meetings in 30 countries. He has provided professional education in pain sciences to over 25,000 medical and health practitioners and public lectures to as many again. His research group’s videos and articles have been viewed over 4.5 million times.

Permission to Move is a project established by co-founder of Tame the Beast, Dave Moen. His group offer tools for patients and clinicians looking to improve chronic pain. It is an online course for patients looking to overcome their chronic pain, and a set of tools for clinicians to use in practice.

You can also view Prof Moseley’s lectures on YouTube. He is a highly respected and renowned figure in the field of pain science and neuroscience. He has made significant contributions to our understanding of chronic pain and has played a crucial role in challenging traditional beliefs and perceptions surrounding this complex phenomenon. Beyond his academic achievements, Lorimer is known for his engaging and passionate teaching style. He frequently presents at international conferences, delivers captivating TED talks, and provides educational workshops to healthcare professionals. His ability to translate complex scientific concepts into accessible language has made him a sought-after speaker and educator.


The app that makes chronic pain self-care easy, engaging and accessible from home.

Modern neuroscience is illuminating more and more about how chronic pain develops and worsens. Study after study from the best scientists and institutions in the world shows that the brain and central nervous system play a much more significant role in chronic pain than we once thought. By retraining the brain to process pain differently, we can reduce symptoms and gain more control.

The aim of the Curable app is to reach every person with chronic symptoms and present them with the opportunity to improve their lives.


A referral letter from your GP, Consultant, Physiotherapist or Chiropractor is advisable. Referrals can be sent either through the online referral form or through email at Alternatively, referrals can be faxed to us on 0117 2140301.

A word of caution about case reports and reviews from our patients

Case reports available on our website are from real patients that Dr Krishna has treated. We are proud that these patients have responded positively to our treatments and their quality of life has improved significantly from our treatments. Some of these patients have very kindly provided us with reviews as shown on our website. These reviews are aimed at providing honest information to other patients who are seeking medical treatments for similar conditions.

For many patients, the experience of speaking with someone who appears to understand and has an answer is naturally a wonderful experience. The willingness to believe this will work is powerful, and people want to share their positive experiences. However, this can create a bias in reporting, and give the impression that an intervention is likely to work.

When you are in pain, you are desperate and you’ll try anything. It is important that patients analyse all the available information very carefully and understand the implications of having certain treatments. Just because something is widely shared doesn’t make it factually correct. In the same way, just because one patient has benefitted from a particular treatment does not mean that others would benefit as well. The vice versa would be true as well.

Evidence-based medicine (EBM) is the conscientious, explicit, judicious and reasonable use of modern, best evidence in making decisions about the care of individual patients. EBM integrates clinical experience and patient values with the best available research information. However, research takes time and costs a lot of money. There is a paucity of evidence when it comes to several pain conditions because chronic pain is complex and multifactorial. It is important that the clinician be transparent and clearly explains to the patient the lack of evidence with certain treatments, thereby enabling the patient to make an informed decision regarding their care.


What will happen at the 1st appointment?

The aim of the 1st appointment is to perform a full assessment of your pain and any related conditions. Dr Krishna will take a detailed history, perform an appropriate examination and organize any investigations if needed. He will ask you various questions regarding your pain and general health. He will also ask questions about your sleep, mood and activities as these are closely linked to your pain problem. He may ask you some questions regarding your family and work.
Dr Krishna will ask you details of any medications you are taking for your pain or for any other medical conditions. Please bring a copy of your current prescription if available. Please do not forget to tell Dr.Krishna about any blood-thinning medications you are taking. These include warfarin, aspirin, clopidogrel, rivaroxaban, dabigatran, apixaban, heparin and so on.
Dr Krishna will also need details of any investigations you have had in the past with regards to your current pain problem. Please bring copies of reports if available and also clinic letters from previous consultations with other specialists if this is relevant to your current problem.
Your appointment with Dr. Krishna will last up to 45 minutes. Dr. Krishna will discuss various treatment options including medications, interventional treatments (injections) and rehabilitation. Dr. Krishna will be happy to answer your queries and clear any doubts that you may have regarding the management plan. Following your consultation with Dr. Krishna, you will receive a detailed letter, a copy of which will be sent to your GP and any other specialist currently involved in your care.

Follow up appointment

Every patient undergoing treatment (injections or otherwise) with Dr Krishna will be offered a follow-up appointment. Follow up appointments are NOT FREE. The current fee for a follow-up appointment is £150.00.

The aim of the follow-up appointment is to assess the progress you have made following your initial consultation/treatment with Dr Krishna. Depending on your progress Dr Krishna will discuss further management options including medications and interventional treatments (injections). A follow-up appointment will last up to 30 minutes depending on your needs and you will have ample opportunities to ask questions.

How can I pay?

Once your appointment is confirmed, you will be emailed a payment link in the name of Pain Spa Limited. This is a secure link from world pay and you can safely use your credit or debit card to make a payment.

If you prefer to make a bank transfer, please ring (0117 2872383) or email us ( for our bank details.

All payments need to be made prior to your appointment date/ time. Delay in payment may result in the cancellation of your appointment.

Frequently Asked Questions

You can read our frequently asked questions using the button below.


Downloads and Videos

We provide various information documents and videos you may find useful on our Downloads and Videos page which you can visit using the button below.

Downloads & Videos