Maintaining Flexibility May Be the Key to Living Well With Chronic Pain

Chronic pain impacts around 20 per cent of the population. Along with the medical and physical effects it can have far-reaching consequences for employment, lifestyle and mental health.

A new Edith Cowan University (ECU) study has found that for people living with chronic pain it’s not necessarily how intense their pain is, but the extent to which it interferes with their daily life that can pose the biggest threat to their mental health.

ECU researchers Tara Swindells and Professor Joanne Dickson surveyed more than 300 people living with non-cancer-related chronic pain. Participants answered questions about their mental wellbeing, their ‘pain intensity’ and how much pain interfered (‘pain interference’) with their simple everyday pursuits and activities that mattered to them.

Professor Dickson said their research findings suggest that as a result of pain, people might not have the psychological and/or physical capacity to participate in activities that help them attain their personal goals, which can have significant implications for their mental wellbeing.

“The good news is that this research showed personal goal flexibility (i.e., the ability to adapt and to adjust to life’s difficulties and obstacles) in how we strive to maintain or achieve the things that matter to us can provide a protective buffer in maintaining and promoting mental wellbeing,” she said.

The mental health impact

Counter to prediction, Ms Swindells said the study showed ’pain interference’ was reported as more problematic than ‘pain intensity’ for people living with chronic pain.

“These results suggest that it may be the pain interference on daily life, rather than the intensity of the pain, that impacts more negatively on mental wellbeing,” she said.

“Based on our results, it would seem that people can find ways to maintain their mental wellbeing when their pain intensity is high, so long as it does not interfere with important aspects of their daily life.”

How being ‘mentally’ flexible helps

Ms Swindells said the study investigated how persistently pursuing valued goals (goal tenacity) and adjusting those valued goals in response to setbacks or obstacles (goal flexibility) might help to explain how some individuals with chronic pain maintain a sense of mental wellbeing.

“The findings highlighted, for the first time, that distinct goal motivational processes appear to have a protective and buffering effect in maintaining mental wellbeing in those with chronic pain,” she said.

“Specifically, we found that goal flexibility and goal tenacity seem to buffer the negative emotional impacts of pain interference on mental wellbeing, and flexibility even more so than tenacity.

“So if you’re able to adjust, adapt and find ways to still achieve what matters to you most in the face of life’s obstacles, that’s going to help protect your mental wellbeing.”

Ms Swindells emphasised pain management and mental health are multi-faceted.

“Previous pain-related research has shown that physical factors (e.g., sleep, injury, disease) and social factors (e.g., employment, social support, economic factors) play a significant role in pain management,” she said.

“The findings from our study add to this body of knowledge. They indicate that variations in adaptive psychological processes provide another useful lens to understand the relationship between pain interference and mental wellbeing. “

The findings from this study have implications for informing public health policy developments and public health campaigns focused on promoting psychological strengths rather than deficits, for example positive self-care messaging related to pain management.

Reference: Swindells T, Iddon J, Dickson JM. The role of adaptive goal processes in mental wellbeing in chronic pain. Int. J. Environ. Res. Public Health. 2023;20(2):1278. doi: 10.3390/ijerph20021278

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