The impact of organic and psychological pain beliefs on pain, disability, kinesiophobia, catastrophizing, and pain knowledge in shoulder pain: A cross-sectional study

Abstract

Purpose: The purpose of this research is to examine the effects of organic pain beliefs (OPB) and psycho- logical pain beliefs (PPB) on pain intensity, disability, kinesiophobia, catastrophizing, and pain knowledge in chronic shoulder pain. Design: Cross-sectional observational study. Methods: In this cross-sectional study, 109 patients (66 females, 43 males; mean age 49.8 ± 10.4 years) with chronic rotator cuff–related shoulder pain were recruited using a convenience sampling method and completed the Pain Beliefs Questionnaire (PBQ), the Numeric Pain Rating Scale (NPRS), the Shoulder Pain and Disability Index (SPADI), the Tampa Scale for Kinesiophobia (TSK), the Pain Catastrophizing Scale (PCS), and the Revised Pain Neurophysiology Questionnaire (Revised-NPQ). Pearson correlation and mul- tiple linear regression analyses were used to assess the relationships of OPB and PPB with the outcome measures. Results: OPB were significantly positively correlated with activity-related pain (r = 0.30, p = .001), dis- ability (SPADI total; r = 0.21, p = .025), kinesiophobia (TSK; r = 0.42, p < .001), and catastrophizing (PCS; r = 0.40, p < .001), and were negatively correlated with Revised-NPQ (r = –0.34, p = .001). In multiple re- gression models, OPB significantly predicted greater disability ( β= 0.25, p = .013), kinesiophobia ( β= 0.45, p < .001), and catastrophizing ( β= 0.44, p < .001), explaining 4.8%-17.4% of variance in these outcomes (adjusted R ²= 0.048-0.174). Conclusions: In chronic shoulder pain, OPB show weak to moderate associations with adverse clinical outcomes and a negative association with pain knowledge, whereas PPB are not significantly related to outcomes. These findings support the potential value of targeting maladaptive beliefs and improving pain knowledge within rehabilitation. Clinical implications: Evaluating OPB and PPB in relation to pain-related parameters, kinesiophobia, and catastrophizing may help identify at-risk patients and support individualized rehabilitation and targeted education in chronic shoulder pain.