Activity related pain in patients with musculoskeletal disorders : an explorative study

Abstract

Chronic musculoskeletal pain is a common health problem and a major cause for disability pension in Norway. Increased pain and fear related to general activity and exercise may be a barrier to rehabilitation of patients with chronic muscular-skeletal disorders. <br>The aim of the present research was to investigate the occurrence of activity related pain, and to explore its association with fear, psychological distress, self efficacy and pain (duration and distribution). The second aim was to explore how these psychological aspects and activity related pain associates with individuals’ readiness to adopt a self-management approach to pain, and how patients described and explained such pain experiences. <br>Data were collected by questionnaires and qualitative interviews with out-patients at a Physical Medicine clinic at the University Hospital of Northern Norway. Results showed that a majority of the participants experienced increased pain during activity. Pain related fear of movement/(re)injury was a unidimensional construct, which was statistically significantly associated with increased pain during activity, also among individuals without psychological distress. Participants with high levels of fear of movement/(re)injury and psychological distress and weak sense of (pain) self efficacy were more likely to report pain during activity. They were also less ready to take a self-management approach to pain. Activity related pain was described and explained as a complex experience with diverse meanings. Initial fear of pain was re-interpreted under the influence of time, learning and own experience. Participating in social life situations was an important incentive to stay active despite pain.