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Improve Self-efficacy, Improve Pain. Improve Health

Chiropractors, Athletic Therapists, Strength and Conditioning Specialists and other health care providers, on occasion, have to become amateur psychologists when dealing with pain or changing someone’s lifestyle habits.  A major factor that influences our ability to succeed at managing pain or changing lifestyle habits is our clients’ self-efficacy.
 
What is self-efficacy?

 

 

 
Self-efficacy is defined as one’s perceived ability to perform and successfully complete a task. Examples of tasks may be starting and completing a weight loss program, or coping with neck pain or the pain of arthritis.
 
Those with poor self-efficacy will figure they are unable to get in shape or to be healthy therefore they are more apt to quit when they do not see successes. They may decide to not even try. Improving your poor self efficacy will increase your perceived ability to succeed at an exercise program or adhering to lifestyle changes that will help you improve your health. 
 
Research has also found that those will poor self-efficacy will have less ability to cope with pain.  There is a high association between poor self-efficacy and chronic pain.  Pain medication use is higher in those with poor self-efficacy.  This affect has been shown in a number of research studies from chronic pain to pain associated with cancer. 
 
Factors affecting self-efficacy

 

 

 
Depression and anxiety are associated with poor self-efficacy. If a person is anxious that an activity or movement is going to cause neck pain it reduces their perceived ability to accomplish that activity.  They may avoid performing that activity or if they do perform the activity their pain is worse because of it (even if there is no physical damage occurring).  Other factors that negatively influence self-efficacy are feeling tense, fearful or feeling fatigued.
 
Those who have an external locus of control (you feel your environment controls your success) tend to have poor self-efficacy while those with internal locus of control (you control your own success) tend to have high self-efficacy.  A person with an external locus of control may lead to a reliance on external form for their care. 
 
How to Improve Self-efficacy?

 

 

 
Self-efficacy is learned and improvement is acquired through performance accomplishments, vicarious learning, verbal persuasion and management of emotional states (fear, anxiety, and depression).

 

 
Self-efficacy and Exercise

 

 

 
            Some people don’t pursue sports or exercise because they feel as though they will not be capable of performing such activities.  Those with higher self-efficacy will pursue new fitness challenges because they are confident that they will succeed.  Here are a few examples of how you can improve your self-efficacy in terms of becoming fit and healthy. This can easily be applied to changing physical and nutritional habits.
 
  1. Choose simple activities at first.  Don’t decide that to get in shape you will run a day starting tomorrow.  The likelihood of succeeding at that challenge, unless you are a marathon runner, is very poor.  Choose simple activities like a 5 minute walk around the block and whichever speed you feel comfortable.  Stick with this activity for a week. How do you feel about that? It was easy to accomplish and you were successful at accomplishing it. Now choose a task that is a little more of a challenge.  With each successive accomplishment you will feel more and more confident and have greater self-efficacy in performing aerobic activity.  You can apply this concept to any health habit you wish to change.
  2. Watch others performing the same activity successfully.  This is especially effective if you watch others who are similar to you.  This may explain the success of the show Biggest Loser. 
  3. Have someone who will support you.  Seek out a friend, personal trainer, or a health care professional like a Chiropractor who can be there for you.  They can help you by encouraging you to attempt new challenges and congratulating you when you succeed at difficult tasks.
 
Self Efficacy and Pain Management

 

 

 
There are those with pain who are fearful of performing any activity that they perceive might aggravate their pain.  If they experienced pain once with that movement they will likely avoid that movement.  The problem with this approach is that it ends up that not just one activity is avoided but several are avoided.  The body becomes de-conditioned and the chance of further injury is increased as well as a reduction in ones quality of life. 
 
To offset this fear, your Chiropractor or other health care professional needs to challenge the body with movements that are mildly difficult but have a chance for success.   With success, and yes some discomfort, you will become more confident in accomplishing movements that once were thought to be pain inducing.  It should be noted that since chronic pain is not a result of tissue damaging pain.  It is a result of a heightened sensitivity to pain as well as an improper interpretation of other stimuli as pain. With the addition of challenging, yet accomplishable, movements fear will be lessened and self efficacy will be enhanced.  As a result, the ability to manage pain will be improved.
 
In addition, your Chiropractor or other health care professional should be providing you with “tools” to help take care of yourself so you have more control (internal locus of control) rather than just relying 100% on others (external locus of control).
 
If you suspect that you are suffering from depression or anxiety you should bring this up with your Chiropractor, your medical doctor or a Psychiatrist/Psychologist. 
 
Conclusion

 

 

 
Self efficacy can be learned.  Improving your self-efficacy can make a difference in coping with your pain or making lifestyle changes which will allow you to achieve better health.
 
 
References

 

 

 
Applebaum SH, Hare A. Self-efficacy as a mediator of goal setting and performance. Journal of Managerial Psychology, Vol. 11 No. 3, 1996, pp. 33-47.
Bandura A, et al. Perceived Self-Efficacy and Pain Control: Opioid and Nonopioid Mechanisms. Journal of Personality and Social Psychology 1987, Vol. 53, No, 3, 563-571.

 

Blamey R, et al. Patterns of analgesic use, pain and self-efficacy: a cross-sectional study of patients attending a hospital rheumatology clinic. BMC Musculoskeletal Disorders 2009, 10:137 doi:10.1186/1471-2474-10-137.
Ersek M, et al. Results of a Randomized Controlled Trial to Examine the Efficacy of a Chronic Pain Self-Management Group for Older Adults. Pain. 2008 August 15; 138(1): 29–40. doi:10.1016/j.pain.2007.11.003.
Porter, LS, et al. Self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their informal caregivers: Associations with symptoms & distress. Pain. 2008 July 15; 137(2): 306–315. doi:10.1016/j.pain.2007.09.010.
Sarkar U, et al. Self-Efficacy as a Marker of Cardiac Function and Predictor of Heart Failure Hospitalization and Mortality in Patients With Stable Coronary Heart Disease: Findings From the Heart and Soul Study. Health Psychol. 2009 March ; 28(2): 166–173. doi:10.1037/a0013146.

Originally posted 2010-06-30 02:11:00.