Psychological Factors That Modulate The Symptoms
As it happens with almost all types of pain, psychological factors may play a significant role in terms of how pain is felt and when. In some cases, psychological factors can worsen the patient’s prognosis and quality of life. The most important factors are:
- Emotional and mental health, which may worsen the sensation of pain and affect shoulder function and disability. Interestingly, a study shows that 1/4 of patients with rotator cuff tendinopathy also suffer from anxiety or depression.
- Fear-avoidance beliefs such as being afraid of pain and avoiding trigger movements make patients feel even more pain. These patients are known to have a worse outcome of surgery, especially if they don’t complete their physiotherapy as they should.
- Self-efficacy is also related to pain. People with self-efficacy feel secure about themselves and their capabilities, and chronic pain is usually reduced in these cases.
- Sleep problems are a cause and a consequence of shoulder pain, and up to 90% of patients also have insomnia or another sleep disturbance.
For these reasons, your doctor may sometimes recommend a visit to the psychologist to address factors that can contribute to the problem. Different cognitive behavioral strategies can help patients with these problems have a better treatment outcome.