Coping with pain: Prevalance of pacing in patients attending a multidisciplinary pain treatment program

Abstract

Achieving a more consistent pattern of activity through the use of pacing is frequently identified as an effective strategy for managing pain and a desirable outcome of treatment for individuals experiencing chronic pain. Despite its assumed significance in the management of chronic pain, little is known about the prevalence of this activity pattern in patients seeking treatment for chronic pain or its relationship to other measures of functioning. The present study examined the prevalence of this pattern of activity and its relationship to others measures of psychosocial functioning in patients completing a multidisciplinary group pain management program. Patients completed a measure of their use of pacing at the beginning and end of treatment as part of a larger battery of questionnaires. A subset of patients also completed a questionnaire asking them to identify factors that limited their use of this strategy. Patients reported a relatively low use of pacing with 12% reporting that they did not use pacing at all and 38% reporting that they used pacing only somewhat. Men were significantly more likely than women to use pacing. Patients who were older or had been in pain for a longer period of time were more likely to use pacing. The use of pacing was associated with lower levels of depression and less fear of reinjury due to movement. However, the use of pacing was not related to perceived levels of pain intensity, perceived disability, or overall level of activity. Factors identified by patients as limiting their use of pacing included losing track of time while engaged in an activity and negative feelings associated with terminating an activity before its completion. Pacing was used somewhat more frequently at the end of treatment relative to the beginning. Limitations of the present study, implications for future research and treatment are discussed.