Pain Self-Efficacy and Preoperative Opioid Use: Study Summary

Study Citation

Mo KC, Gupta A, Movsik J, Covarrubius O, Greenberg M, Riley LH III, Kebaish KM, Neuman BJ, Skolasky RL. Pain Self-Efficacy (PSEQ) score of <22 is associated with daily opioid use, back pain, disability, and PROMIS scores in patients presenting for spine surgery. The Spine Journal. 2023;23(5):723–730. PMID 37100496. DOI 10.1016/j.spinee.2022.12.015.

Read the indexed abstract on PubMed.

What the Study Examined

This was a retrospective review of prospectively collected preoperative questionnaire data from 578 elective spine-surgery patients at one institution. The investigators examined whether pain self-efficacy, measured with the Pain Self-Efficacy Questionnaire (PSEQ), was associated with daily opioid use and other patient-reported measures before surgery.

Main Finding

A PSEQ score below 22 was associated with twice the odds of reporting daily preoperative opioid use compared with a score of 22 or higher. Lower scores were also associated with greater pain and disability, lower patient activation, and less favorable PROMIS measures in several domains.

What the Study Does Not Show

The study found associations in a single preoperative cohort. It did not establish that a low PSEQ score causes opioid use or poor recovery, test a Greenberg Spine screening protocol, prove that PSEQ predicts an individual patient’s postoperative result, or show that a minimally invasive operation improves self-efficacy.

The useful clinical lesson is narrower: psychosocial and functional measures can add context to a preoperative assessment, but they must be interpreted with the diagnosis, examination, imaging, prior treatment, health factors, and patient goals.

Dr. Greenberg’s Role

Marc Greenberg, MD is listed as a coauthor of the published study. This page summarizes the article and its limitations; it does not present the study as Greenberg Spine practice-specific outcomes data.