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Summary: A new study reveals that the way people think about and cope with chronic pain is more important than the pain itself in determining physical activity levels. The researchers found that people with higher pain resilience (the ability to maintain positive functioning despite pain) were significantly more active than those with lower resilience.
Factors such as pain intensity or fear of movement made little difference once resilience was considered. The findings suggest that interventions focused on building psychological resilience could transform chronic pain management and improve overall health.
Key facts:
Pain resilience matters: High resilience predicted greater physical activity regardless of pain intensity. Mind over pain: Fear of movement and pain sensitivity had little effect once resilience was taken into account. Therapeutic potential: Strengthening resilience could help patients stay active and improve well-being.
Source: University of Portsmouth
Pain affects activity levels, but how people understand and act on pain can make a difference, according to a new study from the University of Portsmouth.
The paper, published in PLOS One, identified that pain resilience (how well people cope with pain) affects physical activity regardless of pain, and increasing resilience could improve both pain management and overall health.
Led by Dr Nils Niederstrasser from the School of Psychology, Sport and Health Sciences at the University of Portsmouth, the study analyzed data from 172 participants suffering from chronic pain, using statistical models to understand how pain resilience affects the relationship between pain and physical activity.
The study examined factors such as fear of movement, frailty, number of painful areas, duration and intensity of pain, both individually and together, to identify which had the most influence on activity levels.
It found that high pain resilience was the key component associated with higher levels of physical activity, while other aspects such as kinesiophobia (fear of movement) did not contribute significantly.
The study suggests that it is not the pain itself, but how well people cope with it that largely determines activity levels. This underscores the central role of pain resilience, which remained a key predictor of activity even after accounting for pain intensity, emphasizing the need to build resilience rather than focusing solely on reducing pain.
Dr Niederstrasser, from the University’s Faculty of Health and Science, said: “What we found is that it is not how much pain you feel that determines whether you stay physically active, but how you think and respond to that pain, indicating that the way people respond and think about pain matters more than their actual sensitivity to pain.
“We suspected that resilience plays an important role and this study helped confirm that.”
The researchers also concluded that treatments focused on building resilience could help patients with chronic pain become more active and improve their overall health.
Dr. Niederstrasser added: “People with greater resilience are able to maintain a positive attitude and overcome discomfort, and this psychological factor is a better predictor of physical activity than the intensity of the pain itself.
“This is a significant shift from historically focusing on negative factors such as fear of movement to understanding the power of positive psychological resilience in chronic pain management.”
This research builds on a previous study by Dr. Niederstrasser that showed that high levels of physical activity can reduce the risk of developing chronic pain. The research detailed how pain prevention programs should include exercise, weight management and supporting social inequalities.
“In the future, more research could examine whether improving resilience in people with chronic pain leads to higher levels of activity, potentially through targeted interventions,” Dr. Niederstrasser added.
Key questions answered:
A: Pain resilience is the psychological ability to maintain activity and positivity despite chronic pain, helping people function better even when discomfort persists.
A: Activity levels were not determined by how much pain participants felt, but by how well they coped with that pain, emphasizing mindset over sensation.
A: Treatments can shift the focus from reducing pain to building resilience through psychological training, motivation and support to help patients stay active.
About this news about pain research.
Author: Lauren Harrison
Source: University of Portsmouth
Contact: Lauren Harrison – University of Portsmouth
Image: Image is credited to Neuroscience News.
Original research: Open access.
“Indirect associations of pain resilience and kinesiophobia with the relationship between physical activity and chronic pain” by Nils Niederstrasser et al. PLUS ONE
Abstract
Indirect associations of pain resilience and kinesiophobia with the relationship between physical activity and chronic pain
Background
Pain is associated with a decrease in physical activity in most people. However, some people manage to maintain physical activity levels despite the pain. While the exact psychological mechanisms behind this are unknown, it is possibly due to low kinesiophobia and high levels of pain resilience. This study aimed to examine the direct and indirect associations of pain resilience and kinesiophobia with the relationship between pain and physical activity.
Methods
In this cross-sectional study, data were collected from 172 participants suffering from chronic pain. Three path models were fitted to assess indirect associations between pain resilience and kinesiophobia in the relationship between physical activity and musculoskeletal pain individually and simultaneously. Additionally, a linear regression model was fitted to examine the impact of psychological predictors of physical activity taking into account musculoskeletal pain.
Results
Significant proportions of the association between musculoskeletal pain and physical activity occurred through both pain resilience and kinesiophobia. However, when examined simultaneously, only indirect associations through pain resilience remained significant. Similarly, when predicting physical activity levels, only high levels of pain resistance and male sex were associated with higher levels of physical activity, while kinesiophobia was not.
Conclusions
This highlights the central role that pain resilience plays in retaining physical activity levels when faced with chronic pain. It also implies that pain resilience predicts physical activity levels beyond pain intensity, kinesiophobia, pain duration, and pain spread. Therefore, it is imperative to examine avenues to increase pain resilience among people suffering from chronic pain, not only to improve their pain, but also their overall health and well-being.
This possibly has implications for clinical practice and may inform treatment approaches, whereby pain resistance can be increased to increase physical activity levels. However, given the cross-sectional design, longitudinal and experimental studies are needed to confirm causal pathways.
