Institutional members access full text with Ovid®

Share this article on:

Pain-related Activity Management Patterns and Function in Patients with Fibromyalgia Syndrome

Racine Mélanie PhD; Galán, Santiago MSc; de la Vega, Rocío PhD; Tomé Pires, Catarina PhD; Solé, Ester PhD; Nielson, Warren R. PhD; Miró, Jordi PhD; Moulin, Dwight E. MD; Jensen, Mark P. PhD
The Clinical Journal of Pain: Post Acceptance: June 06, 2017
doi: 10.1097/AJP.0000000000000526
Original Article: PDF Only


To clarify the importance of avoidance, pacing and overdoing pain-related activity management patterns as predictors of adjustment in patients with Fibromyalgia Syndrome (FMS).


A total of 119 tertiary care patients with FMS who agreed to be part of an activity management pain program completed a survey, which requested information about demographics, pain intensity and pain interference, psychological and physical function, and pain-related activity management patterns. Hierarchical regression analyses were used to identify the unique contributions of the three different pain-related activity management patterns (avoidance, pacing and overdoing) to the prediction of pain interference, psychological function and physical function.


The avoidance pattern was a significant and unique predictor of worse psychological and physical function as well as greater pain interference. Pacing was significantly associated with less pain interference and better psychological function, whereas overdoing was not found to predict patient functioning.


The findings confirm the importance of pain-related activity management patterns as predictors of patient function, and support the necessity of addressing these factors in chronic pain treatment. In addition, the results suggest that targeting increases in activity pacing and decreases in pain avoidance, specifically, might yield the best patient outcomes. However, further research to evaluate this possibility is necessary.

Funding sources: Dr. Mélanie Racine’s salary and travel support for writing this manuscript were funded by The Earl Russell Chair in Pain Research, Western University, London, Ontario, and by a bequest from the estate of Mrs. Beryl Ivey to Dr. Warren R. Nielson. Financial support for this project was provided, in part, by grants from Obra Social de Caixabank, Universitat Rovira i Virgili (PFR program), the Spanish Ministry of Economy and Competitiveness (PSI2012-32471, PSI2015-70966-P) awarded to JM. JM’s work is supported by the Institució Catalana de Recerca i Estudis Avançats (ICREA-Acadèmia), and Fundación Grünenthal. RV’s work is supported by a Beatriu de Pinós Postdoctoral Fellowship (2014 BP-A 00009) granted by the Agency for Administration of University and Research Grants (AGAUR). RV travel is supported by the R2B grant (grant for the enhancement of knowledge) by the Universitat Rovira i Virgili.

Disclosure/Conflict of interest information: The authors declare no financial or other relationships that might lead to a conflict of interest related to this study.

Reprints: Mélanie Racine, PhD, 1635 rue Mégantic, Saint-Hubert, Montreal, Qc, H4B 2K1 CANADA (e-mail:

Received July 25, 2016

Accepted May 31, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.