395: Biopsychosocial factors may explain shoulder pain and disability in chronic shoulder pain

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary musculoskeletal pain, Physiotherapy

Background and Aims: Shoulder pain is one of the most prevalent musculoskeletal conditions, with pain intensity and disability being the most frequently reported complaints. Psychological factors, including catastrophizing, anxiety, depression, and low self-efficacy, have been shown to contribute to symptom persistence and poor treatment outcomes. However, evidence integrating demographic and clinical variables remain limited, resulting in a gap in understanding the biopsychosocial factors associated with shoulder pain and disability. This study determined whether the integration of sociodemographic and psychological aspects can explain shoulder pain and disability in individuals with chronic shoulder pain.

Methods: 112 individuals (46 women; 39.9±11.5 years) with chronic shoulder pain (pain duration: 47.3±59.0 months) were evaluated. Sociodemographic data (sex and age), pain duration, and pain intensity (Numerical Pain Rating Scale) were self-reported. Shoulder pain and disability (Shoulder Pain and Disability Index, SPADI), pain self-efficacy (Pain Self-Efficacy Questionnaire), and kinesiophobia (Tampa Kinesiophobia Scale) were assessed. Multiple linear regression was conducted to examine the association between shoulder pain and disability (dependent variable) and the remaining biopsychosocial outcomes (independent variables). Models were adjusted using the ordinary least squares regression method, with statistical significance threshold set at p<0.05.

Results: The model explained 37.1% of the variance in SPADI scores (R²=0.371; p=0.001). Female sex (95% CI: −16.5; −3.6;), high shoulder pain intensity (95% CI: 2.4; 5.1) and greater kinesiophobia (95% CI: 0.1; 1.1) were associated with higher shoulder pain and disability. Age (95% CI: −0.5; 0.4), pain duration (95% CI: −0.1; 0.1), and pain self-efficacy (95% CI: −0.4; 0.2) did not significantly contribute to the variance in SPADI scores.

Conclusions: Female sex, higher levels of pain intensity and greater kinesiophobia were associated to higher levels of shoulder pain and disability, explaining together 37% of the variance in SPADI scores. However, a multifactorial assessment of individuals with chronic shoulder pain is necessary to comprehensively identify additional factors influencing shoulder pain and disability.

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Presenting Author: Matheus Dias Gregorio
Submitting Author: Matheus Dias Gregorio

Senior Author: Paula Rezende Camargo

IASP 2026 Global Year theme of Neuropathic Pain: No

• Matheus Dias Gregorio: PhD Canditate - Federal University of São Carlos - Departament of Physical Therapy, São Paulo, Brazil
• Melina Nevoeiro Haik: PhD - Federal University of São Carlos - Departament of Physical Therapy, São Paulo, Brazil
• Gabriel Gaspar Ribeiro: Master - Federal University of São Carlos, Departament of Physical Therapy, São Paulo, Brazil
• Lívia Bernardi Nardini: Master Canditate - Federal University of São Carlos, Departament of Physical Therapy, São Paulo, Brazil
• Paula Rezende Camargo: PhD - Federal University of São Carlos, Departament of Physical Therapy, São Paulo, Brazil