Health Locus of Control in Chronic Pain Management
Summary
Health locus of control (HLoC) refers to individuals’ beliefs about the degree to which they can influence their health outcomes, distinguishing between internal, powerful-others and chance orientations. In chronic pain management, these beliefs shape coping strategies, adherence to self-management behaviours and psychological resilience. An internal orientation tends to foster active engagement in rehabilitation, exercise adherence and problem-solving, which can mitigate pain interference and depression. By contrast, external orientations—whether attributing control to healthcare professionals or to chance—may encourage passive coping, heighten disability and amplify distress. Research has employed multidimensional scales to validate HLoC across cultures, to map distinct control-belief patterns and to explore how these perceptions mediate pain-depression pathways. Interventions that recalibrate control beliefs towards adaptive internality, including cognitive-behavioural techniques and tailored education, have demonstrated improvements in function, quality of life and healthcare utilisation on a global scale.
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Health Locus of Control in Chronic Pain Management publication trend
The graph below shows the total number of articles in health locus of control in chronic pain management across all publications each year (not limited to Nature Index journals).
Technical terms
Health locus of control (HLoC): A construct denoting belief patterns regarding who or what governs health outcomes, categorised into internal, powerful-others and chance dimensions.
Internality: The belief that one’s own actions and decisions chiefly determine health status and recovery processes.
Externality: The belief that health outcomes are controlled by external forces, such as healthcare providers or fate.
Passive coping: An avoidance-oriented strategy characterised by reliance on others and minimal active symptom management.
Active coping: A proactive strategy involving behaviours such as exercise, problem-solving and seeking information to manage pain.
Kinesiophobia: An excessive, irrational fear of movement based on the belief that activity will provoke injury or worsen pain.
References
- The pain, depression, disability pathway in those with low back pain: a moderation analysis of health locus of control. Journal of Pain Research (2017).
- Psychometric Properties of the Multidimensional Health Locus of Control Scale Form C in a Non-Western Culture. PLOS ONE (2014).
- Locus of Control Patterns in Headaches and Chronic Pain. Pain Research and Management (2013).
- Age as a moderator in the interplay among locus of control, coping, and quality of life of people with chronic pain. Pain Medicine (2023).
- Influence of the type of locus of health control on the levels of disability and kinesiophobia in chronic low back pain. Brazilian Journal Of Pain (2021).
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