When It Comes to Physical Activity, Resilience Outweighs Chronic Pain
/By Pat Anson
It’s not uncommon for someone with chronic pain to reduce their physical activity and become more sedentary. Believing that movement will make pain worse can even lead to kinesiophobia – an irrational fear of physical activity.
But some people with chronic pain are able to remain physically active and cope with their pain – what’s known as pain resilience. Is that because they have less pain or more resilience?
A new study, published in PLOS One, suggests that resilience predicts physical activity more than pain does, and that boosting resilience should be a part of pain management.
Researchers at the University of Portsmouth in the UK surveyed 172 adult volunteers suffering from chronic pain. Their goal was to understand how pain resilience affects the relationship between pain and movement.
Participants were asked about their pain levels, what kind of physical activities they engaged in, and if they agreed or disagreed with a series of statements such as:
“I am afraid that I might injure myself accidentally.”
“My pain would probably be relieved if I were to exercise.”
“When faced with pain I avoid negative thoughts.”
“When faced with pain I get back out there.”
Based on their answers, participants were given scores that ranked their resilience and kinesiophobia levels, which were then compared to their physical activity.
Researchers found that pain resilience predicts physical activity more strongly than pain intensity.
“We suspected resilience plays a major role, and this study helped confirm that,” said lead author Nils Niederstrasser, PhD, Senior Lecturer in Psychology at the University of Portsmouth.
“What we found is that it's not how much pain you're in that determines whether you stay physically active -- it's how you think about and respond to that pain, indicating that how individuals respond to and think about pain matters more than their actual pain sensitivity.”
Niederstrasser and his colleagues believe that treatments focused on building resilience could help chronic pain patients become more physically active.
“People with greater resilience can maintain a positive attitude and push through discomfort, and this psychological factor is a better predictor of physical activity than pain intensity itself,” said Niederstrasser. “This is a significant shift from historically focusing on negative factors like fear of movement, to understanding the power of positive psychological resilience in managing chronic pain."
This research builds on another study by Niederstrasser, which found that regular exercise and weight management can reduce pain levels, and may help prevent acute pain from becoming chronic.
Previous studies have found that being physically active boosts pain tolerance, and that light or moderate activities can have a protective effect against pain that can last for years.
