The role of Self-Efficacy in Chronic Pain—A Case Report Relating Motivation During The COVID-19 Pandemic and a Patient With Chronic Pain

Abstract

Research Objectives To analyze patient outcomes and traditional physical therapy interventions for chronic low back back, and discuss the benefits of incorporating self-efficacy techniques to improve patient independence. Design Retrospective case report. Setting Outpatient physical therapy setting. Participants 48-year-old female with complaints of chronic low back pain that has increased significantly over the last six months due to the societal consequences of COVID-19. The patient's past medical history included mild arthritis of her spine. The medications she was using for pain included Naproxen, and the patient also found relief with Salonpas pain relief patches. Interventions 1. Trunk flexion AAROM, x 10 repetitions, by rolling swiss ball forward on plinth to promote a stretch of the lower back and eliminate fear of mobility. 2. interferential electrical stimulation to low back to decrease pain x 10 min 3. bilateral dynamic hip strengthening on hip abduction machine with 45#, 10 reps x 3 sets each 4. Functional training such as proper lifting mechanics, 5 repetitions of box lifting 5. physiological components aimed to improve self-efficacy Main Outcome Measures 1.numerical pain rating scale 2. Modified Oswestry Low Back Pain Disability Questionnaire Results The patient's pain improved throughout the 6 weeks that she was seen at physical therapy. This is reflected on her scores on the NPRS. Her baseline pain rating was 9.5/10 and by 6 weeks her score decreased to 3/10. The patient also showed improvements on the Modified Oswestry Disability Index, as seen by a decrease from 42% disability to 10% disability. Improvements were seen in the patient's bed mobility, lumbar flexion AROM, bilateral hip strength, and lower abdominal strength. Conclusions This case is an example of someone with chronic low back pain that prior to the pandemic, had enough self efficacy to manager her condition independently. Interventions during physical therapy focused on traditional manual and therapeutic exercise principles as well as physiological components aimed to improve her self-efficacy. Author(s) Disclosures I declare that I have no relevant or material financial interests that relate to the research described in this paper”.