The study was a collaborative effort between researchers from the University of East Anglia (UEA) in Norwich, England, and the University of Hertfordshire in London, England.
Confidence is the key to recovery
The researchers examined data from 1,030 individuals who were undergoing physiotherapy for the treatment of musculoskeletal shoulder pain in 11 NHS trusts and social enterprises across the East of England. From this, the team collated data on 71 patient characteristics and clinical examination findings prior to and during the patient's first physiotherapy appointment. Overall, 811 people provided information on their shoulder pain and function six months following the treatment.
The findings revealed that patients who expected physiotherapy to improve their condition were more likely to recover than those who expected minimal or no benefit.
On the other hand, individuals who were suffering more pain but were confident that they can still do most things despite their pain had a greater chance of recovering better with physiotherapy, unlike others suffering less pain but weren't as confident.
Dr. Rachel Chester, lecturer in physiotherapy at UEA, explained that they chose to study shoulder pain because it is a very common condition that affects people of all ages, and that it causes substantial loss of movement and function, along with symptoms like night pain.
Chester said that while physiotherapy management is effective for many individuals with shoulder pain, it doesn't always work for all patients. The researchers wanted to determine the factors that predict why some patients benefit from treatment more than others.
In the study, the researchers tested the strength of a patient's "pain self-efficacy," or their "belief or confidence in their own ability to successfully complete tasks and reach a desired outcome despite being in pain." (Related: Study links positive thinking in older adults to increased longevity.)
The researchers noted that most of the patients significantly improved during physiotherapy. The most crucial predictor of outcome was a patient's pain and disability at the first appointment. Higher or lower levels were linked to higher or lower levels six months following the treatment.
However, the most interesting finding was that pain self-efficacy could influence this outcome.
Chester shared that the patients who started off with a high level of pain and disability were more confident in their own ability to accomplish certain tasks and reach a desired recovery outcome. They were also less likely to be in pain and have limited function after six months. She added that these patients were more likely to have a better outcome compared to those who reported "a low level of baseline pain and disability but had low pain self-efficacy.”
Chester advised that physiotherapists should try to help patients understand and manage their pain. Ideally, patients should select treatments and exercises that can help them build confidence and optimize their activity levels. This includes helping patients gain the confidence to resume their regular activities even after a flare-up.
Tips for preventing shoulder pain
After you injure your shoulder, you should get enough rest to allow your body to heal and renew from daily stressors. Here are other tips that can prevent shoulder pain after an injury.
- Follow a nutritious diet to boost your overall health.
- Improve your posture. If you have poor posture or if you slouch your shoulders, there's a greater chance that you'll suffer from shoulder pain.
- Quit smoking. Smoking can affect blood circulation to the shoulder and body, which may slow recovery.
Rest, let your body heal, and be confident that you can recover after physiotherapy so you can continue your daily routine even after a shoulder injury.
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