Fear, Perceived Control, and Sleep in Musculoskeletal Pain: What a Cross-sectional Elbow Study and a Sleep Clinician's Guide Report

Physical therapists and physical therapist assistants who treat musculoskeletal pain and want a plain-language account of what the current evidence says about fear, perceived control and sleep.

Licensed physical therapists and physical therapist assistants in outpatient orthopedics, hand therapy, occupational health, and general musculoskeletal practice. Physical therapist assistants may take this course; the content describes their contribution as work carried out under the direction and supervision of the physical therapist.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

Keating C, Puentedura E, Lucado A, Cleland J. The Association of Perceived Controllability, Fear, and Catastrophizing With Pain Experience: Insights From a Cross-sectional Study in Individuals With Lateral Elbow Tendinopathy. JOSPT Open. 2026;4(1):111-120. doi:10.2519/josptopen.2025.0179

Shepherd MH, Neilson BD, Siengsukon CF. The Pain of Poor Sleep: A Clinician’s Guide to Assessing and Addressing Sleep Dysfunction in People With Musculoskeletal Pain Conditions. JOSPT Open. 2026;4(1):12-22. doi:10.2519/josptopen.2025.0198

Scope note

Psychologically informed practice sits inside physical therapist practice. Diagnosing or treating a mental health disorder or a sleep disorder does not. The sleep commentary states that physical therapists are not responsible for diagnosing sleep disorders and should refer to a sleep medicine specialist when screening results are positive.

After completing this course, you will be able to:

1. Describe what the cross-sectional study of adults with lateral elbow tendinopathy reported about pain catastrophizing, continuous pain intensity and fear-avoidance beliefs, and what it reported about chance locus of control and pain.
2. Name the three general screening questions and the three common sleep conditions the clinician's guide says physical therapists should be prepared to screen for, and state when that guide says referral to a sleep medicine specialist is warranted.
3. Distinguish psychologically informed practice and sleep screening that sit within the physical therapist's scope from the diagnosis or treatment of a mental health disorder or a sleep disorder, and explain the physical therapist assistant's contribution under the direction and supervision of the physical therapist.

1. Start Here: How This Course Works
2. Part One: Perceived Controllability, Fear, and Catastrophizing in Lateral Elbow Tendinopathy
3. Who Took Part and What the Researchers Wanted to Know
4. Measuring Beliefs, Pain, and Sensory Function in a Single Visit
5. What the Elbow Study Found
6. Limits of a One-Time Snapshot and What the Authors Concluded
7. Part Two: Assessing and Addressing Sleep Dysfunction in Musculoskeletal Pain
8. Why Sleep and Pain Travel Together
9. A Stepped Approach to Sleep Screening and the Three Common Sleep Conditions
10. Behavioral Sleep Strategies Described for Physical Therapist Practice
11. Where Screening Ends and Referral Begins
12. Bringing It Together
13. Where the Two Papers Agree
14. Where the Two Papers Diverge
15. A Screening and Conversation Approach That Stays Inside Scope
16. What Remains Unanswered
17. Key Takeaways
18. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 1.0 contact hour (60 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. Keating C, Puentedura E, Lucado A, Cleland J. The Association of Perceived Controllability, Fear, and Catastrophizing With Pain Experience: Insights From a Cross-sectional Study in Individuals With Lateral Elbow Tendinopathy. JOSPT Open. 2026;4(1):111-120. doi:10.2519/josptopen.2025.0179
2. Shepherd MH, Neilson BD, Siengsukon CF. The Pain of Poor Sleep: A Clinician's Guide to Assessing and Addressing Sleep Dysfunction in People With Musculoskeletal Pain Conditions. JOSPT Open. 2026;4(1):12-22. doi:10.2519/josptopen.2025.0198