Differences in adaptive and maladaptive psychosocial responses to chronic pain among adults with varying physical activity levels

Abstract

Aim: Chronic pain is a global public health problem that detrimentally impacts people's health and well-being. Physical activity is beneficial and a recommended self-management strategy for adults living with chronic pain. Yet, many of them struggle to meet the public health recommendation of 150+ minutes/week of moderate-vigorous physical activity. Identifying modifiable factors related to physical activity participation is needed. Adaptive (i.e., self-regulatory efficacy to overcome pain and related barriers [SRE-pain], psychological flexibility) and maladaptive (i.e. pain anxiety) responses were the modifiable factors examined in the present study. The purpose was to investigate whether adults living with chronic pain who were sufficiently active, insufficiently active or inactive significantly differed in their adaptive and maladaptive responses to chronic pain.

Methods: Adults with self-reported chronic pain for 6+ months (N = 318) completed an online survey that measured physical activity, psychological flexibility, SRE-pain and pain anxiety. Sufficiently active (n = 139), insufficiently active (n = 91) and inactive (n = 88) groups were identified.

Results: A significant multivariate analysis of covariance (MANCOVA) (p < .001) with univariate follow-up tests illustrated that the sufficiently active individuals reported the highest psychological flexibility and SRE-pain compared to insufficiently active and inactive individuals (p's < .001). Overall, sufficiently active participants responded the most adaptively and least maladaptively to their pain, followed by the insufficiently active. Inactive participants responded the most maladaptively.

Conclusion: Identifying differences in adaptive and maladaptive responses to pain highlights possible modifiable factors to target in future physical activity intervention research that focuses on improving chronic pain self-management.

Keywords: Chronic pain; adaptive; maladaptive; pain anxiety; pain management; physical activity; psychological flexibility; psychosocial responses; self-regulatory efficacy.