Pain intensity, self-efficacy and physical performance in patients with chronic low back pain

Aim: This article describes a study investigating the relationship between pain intensity, self-efficacy and physical performance in patients with chronic low back pain (CLBP) receiving physiotherapy at selected hospitals in Nigeria. Methods: One hundred and forty-two patients (86 female, 56 male) recruited from the out-patient units of the physiotherapy departments of the University of Nigeria Teaching Hospital and the National Orthopaedic Hospital, Enugu participated in the study. The pain intensity in the low back, self-efficacy and physical performance of patients with CLBP were assessed using the Box Numerical Scale, Chronic Pain Self-Efficacy Scale and Back Performance Scale respectively. Results: The participants were aged 48.05 +/- 12.66 years (range 21-65). There was no significant correlation (r=0.051; P=0.548) between pain intensity and physical performance, but significant negative correlations were obtained between self-efficacy domain scores and physical performance (r values range from -0.239 to -0.414; P values range from 0.000 to 0.004). Self-efficacy for physical function was the only self-efficacy subscale/domain that had no significant correlation (r=-0.030; P=0.719) with pain intensity. Conclusions: An increase in self-efficacy was significantly related to improvement in the physical performance of patients with CLBP, or vice versa. Only the self-efficacy domain of physical function was not significantly related with pain intensity. Recommendations were made for the incorporation of assessment of pain self-efficacy levels in the management of CLBP patients, as well as for the development of strategies to improve it clinically.