Managing usual and unexpected pain with physical disability: a qualitative analysis.
OBJECTIVE
With physical disabilities, persons often experience secondary pain that adds to restrictions in activity and participation. We investigated pain-management strategies used by those with physical disabilities.


METHODS
Qualitative phenomenological inquiry was used in multiple interviews with (N= 28) adults with physical disabilities (9 with amputation, 7 with cerebral palsy, and 12 with spinal cord injury) and subsequent thematic analysis.


RESULTS
Among those with physical disabilities, a distinction is made between usual and unexpected pains. Usual pain is experienced consistently or as a consequence of not getting adequate rest, exercise, or stress-free time. Managing usual pain involves uses of prevention (e.g., exercise/fitness) and/or pragmatic actions through scheduling and pacing daily activities and taking interim retreats. Unexpected pain is experienced periodically and requires an immediate response and change of activity. To manage, persons describe making efforts to create a mind and body disassociation, activating safety nets to support function and alleviate pain, and making decisions to persevere with activity and participation.


CONCLUSIONS
Advising those with physical disabilities to do proactive planning for both usual and unexpected pain may help them to use varied pain-management strategies to enhance function and minimize negative impacts on participation.
Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle 98195, USA. dudgeonb@u.washington.edu
Brian J
BJ
Dudgeon
Erica J
EJ
Tyler
Lorna A
LA
Rhodes
Mark P
MP
Jensen
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D002908:Chronic Disease; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010146:Pain / Q000517:prevention & control*; D059408:Pain Management; D012944:Social Support