Association between psychological determinants (self-efficacy and self-regulation) and lifestyle in chronic musculoskeletal pain: A cross-sectional observational study

Musculoskelet Sci Pract. 2026 Mar 26;83:103550. doi: 10.1016/j.msksp.2026.103550. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic musculoskeletal pain (CMP) affects approximately 22% of the global population and is a major cause of disability worldwide. Current evidence supports an integrated and personalized lifestyle approach as an effective strategy for managing chronic pain. Psychological factors such as self-efficacy and self-regulation may play a key role in promoting healthier lifestyle behaviors, yet their associations with lifestyle in individuals with CMP remain poorly understood.

OBJECTIVES: To investigate the relationship between self-efficacy, self-regulation, and lifestyle behaviors, while accounting for sociodemographic and clinical factors, in adults with CMP.

DESIGN: Cross-sectional observational study.

METHOD: A total of 105 adults receiving secondary or tertiary physiotherapy care were recruited between January 2023 and January 2024. Lifestyle behaviors were assessed using the FANTASTIC Lifestyle Questionnaire, self-efficacy using the Pain Self-Efficacy Questionnaire (PSEQ-10), and self-regulation using the Short Self-Regulation Questionnaire (SSRQ). Sociodemographic and clinical variables were included as covariates in multiple linear regression analyses.

RESULTS: Healthier lifestyle scores were moderately associated with higher levels of self-regulation (β = 0.391, p < 0.001) and weakly associated with self-efficacy (β = 0.295, p = 0.001) and job satisfaction (β = 0.169, p = 0.038).

CONCLUSIONS: Self-regulation and self-efficacy were independently associated with lifestyle in individuals with CMP, with self-regulation showing a stronger association. Job satisfaction also demonstrated a weaker but significant association with lifestyle These findings support the relevance of addressing psychosocial factors within rehabilitation programs aimed at promoting lifestyle-related behavioral change in this population.

PMID:42001596 | DOI:10.1016/j.msksp.2026.103550