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Medicate or Meditate? Greater Pain Acceptance is Related to Lower Pain Medication Use in Persons With Chronic Pain and Spinal Cord Injury

Kratz, Anna, L., PhD; F. Murphy, John, III, BS; Kalpakjian, Claire, Z., PhD; Chen, Philip, MD

doi: 10.1097/AJP.0000000000000550
Original Articles

Objectives: There is little information about whether use of pain self-management skills that are common targets of psychosocial interventions for pain are associated with reduced reliance on pain medications. The aim of this study was to test whether higher chronic pain acceptance, which is a readily modified pain self-management approach, is related to lower use of pain medications (eg, opioid medications, and gabapentinoids) in a sample with chronic pain and spinal cord injury (SCI).

Materials and Methods: This is a cross-sectional survey study of pain medication use, pain severity and distribution (Brief Pain Inventory [BPI]), depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]), and chronic pain acceptance (Chronic Pain Acceptance Questionnaire [CPAQ]) administered to a sample of 120 adults with chronic pain and SCI.

Results: Regression results indicated that, above and beyond the effects of pain intensity, pain distribution, and depressive symptoms, higher pain acceptance was related to lower use of all types of pain medications, and lower odds of using opioid medications or gabapentinoids. Pain intensity was not related to pain medication use, but greater pain distribution was related to using more pain medications in general and to greater odds of using gabapentinoids.

Discussion: Findings from this study indicate that those with chronic pain and SCI who have a more accepting orientation to pain are less reliant on pain medications, and thereby experience lower risks associated with medication consumption. Longitudinal, daily process, and clinical trial studies are needed to better understand the association between pain acceptance and pain medication consumption.

Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI

Research reported in this publication was supported by the Craig H. Neilsen Foundation (Encino, CA) under award number 287372 (PI: A.L.K.). The content is solely the responsibility of the authors and does not necessarily represent the views of the Craig H. Neilsen Foundation. A.L.K. was supported during manuscript preparation by a grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (Bethesda, MD; award number K01AR064275). The authors declare no conflict of interest.

Reprints: Anna L. Kratz, PhD, Department of Physical Medicine and Rehabilitation, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd, Building NCRC B14, Room G218, Ann Arbor, MI 48109-2800 (e-mail:

Received April 7, 2017

Received in revised form July 7, 2017

Accepted August 15, 2017

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