This cross-sectional, correlational study aims to determine the predictors of illness perception and treatment expectations in adults with chronic lateral elbow pain. Sociodemographic characteristics, clinical findings (pain intensity, pain duration, elbow-specific function) and psychosocial variables (pain self-efficacy, fear-avoidance beliefs, pain catastrophizing) will be examined as candidate predictors of two patient-centred constructs: illness perception, measured with the Brief Illness Perception Questionnaire, and treatment expectation, measured with the Treatment Expectation Questionnaire. Data will be analysed using hierarchical multiple linear regression in three predictor blocks. The study is reported according to the STROBE statement.
Aged 18 years or older
Diagnosis of lateral epicondylalgia or lateral elbow pain made by an orthopaedic surgeon or physiatrist
Pain intensity of at least 4 on the Numeric Rating Scale
Pain duration of at least 12 weeks (chronic)
History of any surgical procedure of the upper extremity
Cervical spine pathology
Inflammatory arthritis affecting the wrist or finger joints (e.g. rheumatoid arthritis)
Active neurological disease or radiculopathy radiating to the upper extremity
Adults presenting with lateral elbow pain to a physiotherapy and rehabilitation outpatient unit in Istanbul, Turkey. Consecutive, non-probability sampling of eligible patients who consent to participate.
Cohort
Cross-sectional
Not listed
Illness perception (Brief Illness Perception Questionnaire, B-IPQ)
The B-IPQ is a 9-item self-report instrument assessing cognitive and emotional representations of illness. Eight items are rated on a 0 to 10 numeric scale covering consequences, timeline, personal control, treatment control, identity, concern, coherence and emotional representation; the ninth item is open-ended and asks about perceived causes. The total score ranges from 0 to 80, with higher scores indicating a more threatening perception of the illness.
Treatment expectation (Treatment Expectation Questionnaire, TEX-Q)
The TEX-Q assesses expectations of an upcoming treatment. Fifteen scored items are rated on an 11-point scale from 0 (no expectation at all) to 10 (expecting complete recovery from treatment); six additional items are not included in scoring. Higher scores indicate higher treatment expectation.
Pain intensity (Numeric Rating Scale, NRS)
Self-reported lateral elbow pain intensity rated from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity.
Pain self-efficacy (Pain Self-Efficacy Questionnaire, PSEQ)
Ten items rated on a 7-point Likert scale (0 = not at all confident, 6 = completely confident), giving a total score of 0 to 60. Higher scores indicate greater confidence in performing activities despite pain.
Fear-avoidance beliefs (Fear-Avoidance Beliefs Questionnaire, FABQ)
Sixteen items rated on a 7-point Likert scale from 0 (completely disagree) to 6 (completely agree), assessing beliefs about the effect of physical activity and work on pain. Higher scores indicate stronger fear-avoidance beliefs.
Pain catastrophizing (Pain Catastrophizing Scale, PCS)
Thirteen items with helplessness, magnification and rumination subscales, each rated from 0 (never) to 4 (all the time), giving a total score of 0 to 52. Higher scores indicate greater pain catastrophizing.
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