People with chronic pain face complex dilemmas and life-changing decisions

November 30, 2010

Coping with chronic pain can affect every aspect of a person's life and cause conflict between what their mind wants to achieve and what their body allows them to do, according to research in the December issue of the Journal of Nursing and Healthcare of Chronic Illness.

Swedish researchers carried out in-depth interviews with ten people who had experienced chronic pain for between four and 32 years and were taking part in an outpatient rehabilitation programme. Nine of the patients, who ranged from 22 to 50 with an average age of 38, were unable to work because of their pain.

"A recent research study found that chronic pain affected up to 30 per cent of adults across Europe, impacting on people's everyday lives and in many cases their ability to work" says lead author Asa Skjutar from the Karolinska Institutet.

"Although multidisciplinary rehabilitation programmes for people with chronic pain are well established in Sweden, they don't work for everyone. There can be a number of reasons for this, from failing to customise treatment to individual needs through to delayed intervention which makes people less amenable to change.

"What is clear is that many patients with chronic pain find that their needs are not being met by healthcare professionals. Previous research has found that patients' beliefs play an important role in how successful any interventions are. That is why we were keen to find out how people felt chronic pain impacted on their lives."

Three key themes emerged during the interviews:


Patients expressed conflicts between what they wanted to do and what their body let them do and they were constantly weighing up the consequences of their actions.

One woman described how she had to set her pain aside, grit her teeth and let her mind take the lead as she got her children off to school and daycare. "Had I listened to what hurts, then I wouldn't have done it" she said. Another patient talked about how a fishing trip satisfied his lust for adventure, even though he was aware of the increased pain that might follow.

Others, however, talked about not making definite plans to avoid the guilt of cancelling. They also said that they had no problem in accepting help or stopping what they were doing if they felt their pain levels would escalate.

"The participants had gone though rehabilitation programmes that recommend a steady and moderate level of activity, but said that they had not found the best way to manage their pain" says Asa. "They moved between the two extremes of letting their body and their mind lead and repeated this cycle so that neither dominated."


Patients also spoke about their need to let go of the way they used to live - including their behaviour, daily routines and independence - and find new ways to express themselves. "It's so strange for me to say no" said one participant. "I'm not used to it. Nobody else is used to it either." But she learnt how to say no and, although it was tough, it felt good.

Another patient talked about how he had managed to paint a wall on one side of the house, but was unable to paint the remaining walls. "I am very pleased that it looks so nice even though I know that the other ones aren't done" he said. "Before I wouldn't have looked at that wall, I would've looked at the other ones."

"These transformations didn't happen overnight, they happened bit by bit" says Asa. "But they made people realise that they had made the adjustments they needed to make to their lives to manage their pain."


People who took part in the study also realised that they needed to manage their pain in order to enjoy their lives. They initially focused their energy on work-related roles and finding a fast cure for their pain, but this often led to more pain and feelings of defeat.

Family time and friendships became very important, because social interaction could often be achieved without too much activity. "I'm seeing friends and family again, which means a lot to me" said one participant. It was also important to have a change of scene. "I went to a friend's and played a video game and talked and just had a good time, just relaxed" said another. "It was so nice to get out and do something."

"Doing something they enjoyed gave people energy and made them feel more optimistic and positive" says Asa.

"Understanding how people are affected by chronic pain enables healthcare professionals to give them the support they need to adapt their lives, discover a new way forward and engage with friends and family in a way that enhances their quality of life" she concludes.

"Chronic pain is a very common health problem in adults and its management affects not just people's personal lives and relationships but their contribution to society and the economy. It is vital that we enhance our understanding of people's needs so we can provide more effective chronic pain management services that meet people's varied and changing needs."
Notes to editors

Adapt, discover and engage: a qualitative interview study with patents living with chronic pain. Skjutar A and Mullersdorf M. Journal of Nursing and Healthcare of Chronic Illness. 2, pp 254-261. (December 2010). DOI: 10.1111/j.1752-9824.2010.01066.x

The Journal of Nursing and Healthcare of Chronic Illness is an international peer-reviewed journal for nurses and health care professionals who care for people with chronic illness and research in this area. Chronic diseases and illness are usually of slow progression and long duration. The prevalence of chronic illness is increasing worldwide, hence it is imperative through research that we understand risk factors, evaluate the effectiveness of nursing care and determine the best care strategies.

Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit or our new online platform, Wiley Online Library (, one of the world's most extensive multidisciplinary collections of online resources, covering


Related Chronic Pain Articles from Brightsurf:

Researchers are developing potential treatment for chronic pain
Researchers from the University of Copenhagen have developed a new way to treat chronic pain which has been tested in mice.

Molecular link between chronic pain and depression revealed
Researchers at Hokkaido University have identified the brain mechanism linking chronic pain and depression in rats.

How chikungunya virus may cause chronic joint pain
A new method for permanently marking cells infected with chikungunya virus could reveal how the virus continues to cause joint pain for months to years after the initial infection, according to a study published Aug.

Gastroesophageal reflux associated with chronic pain in temporomandibular joint
Gastroesophageal reflux (GERD) is associated with chronic, painful temporomandibular disorder -- pain in the temporomandibular joint -- and anxiety and poor sleep contribute to this association, according to a study in CMAJ.

One step closer to chronic pain relief
While effective drugs against chronic pain are not just around the corner, researchers from Aarhus University, Denmark, have succeeded in identifying a protein as a future potential target for medicinal drugs.

Gut bacteria associated with chronic pain for first time
In a paper published today in the journal Pain, a Montreal-based research team has shown, for the first time, that there are alterations in the bacteria in the gastrointestinal tracts of people with fibromyalgia.

Nearly 5.4 million cancer survivors suffer chronic pain
A new report finds about one in three cancer survivors (34.6%) reported having chronic pain, representing nearly 5.4 million cancer survivors in the United States.

New opioid speeds up recovery without increasing pain sensitivity or risk of chronic pain
A new type of non-addictive opioid developed by researchers at Tulane University and the Southeast Louisiana Veterans Health Care System accelerates recovery time from pain compared to morphine without increasing pain sensitivity, according to a new study published in the Journal of Neuroinflammation.

New target for chronic pain relief confirmed by scientists
A research group at Hiroshima University observed a potential new target for chronic pain treatment.

Menopause symptoms nearly double the risk of chronic pain
In addition to the other health conditions affected by estrogen, it has also been shown to affect pain sensitivity.

Read More: Chronic Pain News and Chronic Pain Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to