Researchers found it wasn’t the intensity of pain that most affected the mental well-being of chronic pain sufferers, but their mental flexibility.

Chronic pain impacts around 20% 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. 

 Related: Cannabis Use for Managing Chronic Pain Is Increasing, Per Study

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 well-being, their “pain intensity,” and how much pain interfered (“pain interference”) with their simple everyday pursuits and activities that mattered to them. 

Professor Dickson says 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 well-being. 

“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 well-being,” she says. 

Professor Joanne Dickson

The Mental Health Impact 

Counter to prediction, Swindells says 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 well-being,” she says. 

“Based on our results, it would seem that people can find ways to maintain their mental well-being 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  

Swindells says 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 well-being.  

“The findings highlighted, for the first time, that distinct goal motivational processes appear to have a protective and buffering effect in maintaining mental well-being in those with chronic pain,” she says. “Specifically, we found that goal flexibility and goal tenacity seem to buffer the negative emotional impacts of pain interference on mental well-being, 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 well-being.”

Swindells emphasizes that 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 says. 

“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 well-being. “ 

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. 

The paper ‘The Role of Adaptive Goal Processes in Mental Wellbeing in Chronic Pain’ was published in the International Journal of Environmental Research and Public Health.