Structure-Focused Education

Participants receiving SF education were substantially less likely to name exercise as a treatment option compared to those receiving best practice education. Participants in the SF group most often expressed trust in the clinician's expertise, suggesting structural explanations lend perceived authority to the clinician. The finding that structural framing increases perceived need for imaging, surgery, and injections is consistent with a prior qualitative study on shoulder pain education. Structure-focused education emphasizes that structural changes are the primary cause of pain and should be targeted with treatment. SF education led participants to endorse diagnostic imaging, injections, and surgery at substantially higher rates than best practice education. Structural framing nudges patients toward unnecessary and potentially harmful care pathways including imaging, injections, and surgery.