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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; Murphy, John III BS; Kalpakjian, Claire Z. PhD; Chen, Philip MD

doi: 10.1097/AJP.0000000000000550
Original Article: PDF Only

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 (all types), opioid medications, and gabapentinoids in a sample with chronic pain and spinal cord injury (SCI).

Methods: This is a cross-sectional survey study of pain medication use, pain severity and distribution (BPI), depressive symptoms (PHQ-9), and chronic pain acceptance (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 gabapentinoid medications.

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 & Rehabilitation, University of Michigan, 325 E. Eisenhower Parkway, Ann Arbor, MI 48108, USA

Disclosures: Research reported in this publication was supported by the Craig H. Neilsen Foundation under award number 287372 (PI: Kratz). The content is solely the responsibility of the authors and does not necessarily represent the views of the Craig H. Neilsen Foundation. Dr. Kratz was supported during manuscript preparation by a grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (award number K01AR064275). The authors have no conflicts of interest to report.

Reprints: Anna L. Kratz, PhD, Department of Physical Medicine & 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

Accepted August 15, 2017

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