Managing usual and unexpected pain with physical disability: a qualitative analy

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Am J Occup Ther. 2006 Jan-Feb;60(1):92-103

Managing usual and unexpected pain with physical disability: a

qualitative analysis.

Dudgeon BJ, Tyler EJ, LA, Jensen MP.

Division of Occupational Therapy, Department of Rehabilitation

Medicine, University of Washington, Seattle 98195, USA.

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.

METHOD: 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.

CONCLUSION: 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.