OBJECTIVE: To determine whether psychosocial factors such as resilience, perceived stress, catastrophizing, anxiety, depression, pain self-efficacy, and social support, explain the persistence of pain and disability in individuals with RCRSP following an education program. METHODS: One hundred forty-three individuals with persistent RCRSP were included in this prospective cohort study. At baseline, participants completed self-reported questionnaires related to pain, disability, and psychosocial constructs, including resilience, stress, catastrophizing, anxiety and depressive symptoms, pain self-efficacy, and social support. Thereafter, participants took part in an educational program aimed at promoting self-management of RCRSP that included two meetings with a physiotherapist. After 12 and 24-weeks, participants filled only pain and disability questionnaires and based on their scores, were classified as having persistent shoulder pain or as recovered. RESULTS: A univariable modified Poisson regression showed that higher perceived stress (RRadjusted: 1.02
95%CI: 1.01-1.04), catastrophizing (RRadjusted: 1.01
95%CI: 1.01-1.02), symptoms of depression (RRadjusted: 1.03
95%CI: 1.01-1.06) and anxiety (RRadjusted: 1.03
95%CI: 1.01-1.06), along with lower resilience (RRadjusted: 0.90
95%CI: 0.81-1.00), were associated with ongoing RCRSP at 12 weeks. Additionally, reduced pain self-efficacy was associated with persistent pain at both 12 weeks (RRadjusted: 0.98
95%CI: 0.97-0.99) and 24 weeks (RRadjusted: 0.99
95%CI: 0.98-1.00). Multivariable regression indicated that only pain self-efficacy served as a protective factor against persistent RCRSP (RRadjusted: 0.98
95%CI: 0.97-0.99). DISCUSSION: This study sheds light on the impact of psychosocial factors on persistent RCRSP, underscoring the importance of positive beliefs in pain management. Importantly, pain self-efficacy emerges as a key factor in recovery.