Pain self-efficacy may influence an individual’s ability to manage pain and maintain functionality. Lower self-efficacy levels are linked to greater pain, disability, and poorer outcomes. In a frozen shoulder, persistent pain and restricted movement may be associated with low self-efficacy. Psychological factors (depression, anxiety, kinesiophobia, pain catastrophizing) and sleep disturbances are associated with pain and function in musculoskeletal conditions. Still, their contribution to self-efficacy pain in frozen shoulder remains unclear. Understanding these relationships may improve rehabilitation strategies by addressing psychosocial aspects alongside physical treatment.

To analyze the association between pain, disability, psychological factors (anxiety, depression, kinesiophobia, pain catastrophizing), and sleep quality with pain self-efficacy in individuals with frozen shoulder.

This cross-sectional study was conducted via video calls using Google Meet®. Pain self-efficacy was assessed with the Pain Self-Efficacy Questionnaire (PSEQ-10); pain and disability with the Shoulder Pain and Disability Index (SPADI). Anxiety and depression were evaluated with the Hospital Anxiety and Depression Scale (HADS), kinesiophobia with the Tampa Scale for Kinesiophobia-11 (TSK-11), and pain catastrophizing with the Pain Catastrophizing Scale (PCS). Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Multiple linear regression examined pain self-efficacy as the dependent variable and pain, disability, anxiety, depression, kinesiophobia, pain catastrophizing, and sleep quality as independent variables.

A total of 96 individuals participated (72 women; mean age = 53.1 ± 10.8 years; BMI = 26.3 ± 4.8 kg/m²), including 57 with primary and 39 with secondary frozen shoulder. Depression, pain, and sleep quality were significantly associated with pain self-efficacy, explaining 34.4% of the variance (F(3,92) = 17.63, p < 0.000, adjusted R² = 0.344, RMSE = 10.40). The remaining variables were not significantly associated.

Depression, sleep quality, and pain intensity were associated with pain self-efficacy, accounting for 34.4% of its variance. Higher depression levels, poorer sleep quality, and greater pain intensity were linked to lower self-efficacy. These findings highlight the importance of integrating psychological support and sleep hygiene strategies into frozen shoulder rehabilitation.

A comprehensive, interdisciplinary approach addressing psychosocial factors and sleep disturbances may enhance pain self-efficacy and treatment outcomes in frozen shoulder. Incorporating psychological interventions and sleep hygiene into rehabilitation programs could improve adherence and effectiveness.