Self-Efficacy: What Is Your Role in the Sleep and Pain of Patients with Chronic Shoulder Pain?

Dear Editor, According to the International Association for the Study of Pain (IASP), pain is defined as “an unpleasant sensory and emotional experience associated, or similar to that associated, with an actual or potential tissue injury” [1]. Chronic pain, in turn, is that which is persistent or recurrent for a period of at least three months, and sleep disturbances are often found in individuals with this condition [2]. There is a bidirectional relation between pain and sleep, with pain causing a reduction in the duration or quality of sleep, and disturbed sleep affecting the perception of pain by reducing pain thresholds [2]. Chronic shoulder pain is a complex syndrome involving biopsychosocial factors, with kinesiophobia, hypervigilance, catastrophizing, resilience, recovery expectation, and self-efficacy influencing the experience of pain [3]. Self-efficacy is defined as an individual's belief about their ability to perform a certain task and how to behave so that it can be achieved [4]. Therefore, it depends on a number of factors, including cognitive and emotional aspects, and can influence clinical outcomes in musculoskeletal conditions. Thus, knowledge on this topic can be included in pain education offered to patients to help them manage their own condition and reduce their dependence on health services [5]. Moreover, pain self-efficacy has been shown to be more influential on disability, behavior and pain intensity when compared to kinesiophobia and thought catastrophizing in individuals with shoulder pain [3].