Physical disability and the experience of chronic pain


      Dudgeon BJ, Gerrard BC, Jensen MP, Rhodes LA, Tyler EJ. Physical disability and the experience of chronic pain. Arch Phys Med Rehabil 2002;83:229-35. Objectives: To obtain an insider's view about disability-related pain to help rehabilitation clinicians understand the experience and to show how people with disability manage daily living and encounters with other people. Design: Qualitative methods by using open-ended interviews and thematic analysis. Setting: Rehabilitation research program. Participants: Nine adults with chronic physical disability and pain were recruited from study groups. The 9 included people with spinal cord injury, acquired amputation, or cerebral palsy. Intervention: Interview protocol. Main Outcome Measure: Phenomenologic analysis of interviews based on codewords derived from interview topics and themes. Results: Study participants described pain as a part of daily living that influenced many lifestyle decisions. They characterized pain as plural, meaning that it has multiple locations, distinctive descriptions, and different implications. They also were concerned about pain being a mystery, having unclear causes and consequences. Typically they described pain as a personal venture, with little or dissatisfying communication about pain with family, friends, or health care providers. Conclusions: Understanding pain associated with physical disability can help guide rehabilitation practitioners in their pain assessments, interventions, and related research. Our findings suggest that some people with disability-related pain may benefit from reassurance and specific planning for expected and unexpected pain episodes. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. Enabling America: assessing the role of rehabilitation science and engineering. National Academy Pr, Washington (DC)1997
        • Russell JH
        • Hendershot GE
        • LeClere F
        • Howie LJ
        • Adler M.
        Trends and differential use of assistive technology devices: United States, 1994.
        Adv Data. 1997; 292: 1-9
        • Bonica JJ
        Introduction: semantic, epidemiologic, and educational issues.
        in: Pain and central nervous system disease: the central pain syndromes. Raven Pr, New York1991: 13-29
        • Demirel G
        • Yllmaz H
        • Gencosmanoglu B
        • Kesiktas N.
        Pain following spinal cord injury.
        Spinal Cord. 1980; 36: 25-28
        • Rintala DH
        • Loubser PG
        • Castro J
        • Hart KA
        • Fuhrer MJ
        Chronic pain in a community-based sample of men with spinal cord injury: prevalence, severity, and relationship with impairment, disability, handicap, and subjective well-being.
        Arch Phys Med Rehabil. 1998; 79: 604-614
        • Kennedy P
        • Frankel H
        • Gardner B
        • Nuseibeh I.
        Factors associated with acute and chronic pain following traumatic spinal cord injuries.
        Spinal Cord. 1997; 35: 814-817
        • Jensen T
        • Krebs B
        • Nielsen J
        • Rasmussen P.
        Phantom limb, phantom pain and SP in amputees during the first 6 months following limb amputation.
        Pain. 1983; 17: 243-256
        • Jensen T
        • Rasmussen P.
        Phantom pain and other phenomena after amputation.
        in: 3rd ed. The textbook of pain. Churchill-Livingstone, London1984: 402-412
        • Sherman R
        • Sherman C
        • Parker L.
        Chronic phantom and SP among American veterans: results of a survey.
        Pain. 1984; 18: 83-95
        • Smith DG
        • Ehde DM
        • Legro MW
        • Reiber GE
        • del Aguila M
        • Boone DA
        Phantom limb, residual limb, and back pain after lower extremity amputations.
        Clin Orthop. 1999; 361: 29-38
        • Deyo RA
        • Tsui-Wu YJ
        Descriptive epidemiology of low-back pain and its related medical care in the United States.
        Spine. 1987; 12: 264-268
        • Schwartz L
        • Engel JM
        • Jensen MP
        The nature of pain in persons with cerebral palsy.
        Arch Phys Med Rehabil. 1999; 80: 1243-1246
        • Ireland ML
        • Hoffer MM
        Triple arthrodesis for children with spastic cerebral palsy.
        Dev Med Child Neurol. 1985; 27: 623-627
        • Turk MA
        • Geremski CA
        • Rosenbaum PF
        • Weber RJ
        The health status of women with cerebral palsy.
        Arch Phys Med Rehabil. 1997; 78: S10-S17
        • Nollett F
        • Beelen A
        • Prins JH
        • et al.
        Disability and functional assessment in former polio patients with and without postpolio syndrome.
        Arch Phys Med Rehabil. 1999; 80: 136-143
        • Warnell P.
        The pain experience of a multiple sclerosis population: a descriptive study.
        Axone. 1991; 13: 26-28
        • Aronoff GM
        Pain centers: treatment for intractable suffering and disability resulting from chronic pain.
        in: 3rd ed. Evaluation and treatment of chronic pain. Williams & Wilkins, Baltimore1998: 541-602
        • Spencer JC
        The usefulness of qualitative methods in rehabilitation: issues of meaning, of context, and of change.
        Arch Phys Med Rehabil. 1993; 74: 119-126
        • Fuhrer MJ
        Subjective well-being: implications for medical rehabilitation outcomes and models of disablement.
        Am J Phys Med Rehabil. 1994; 73: 358-364
        • Peters DJ
        Qualitative inquiry. Expanding rehabilitation medicine's research repertoire: a commentary.
        Am J Phys Med Rehabil. 1996; 75: 144-148
        • Yin RK
        Case study research: design and methods.
        Sage, Thousand Oaks (CA)1994
        • Miles MB
        • Huberman AM
        Qualitative data analysis.
        2nd ed. Sage, Thousand Oaks (CA)1994
        • Giorgi A.
        Phenomenology and psychological research.
        Duquesne Univ Pr, Atlantic Highlands (NJ)1985
        • Lincoln YS
        • Guba EG
        Naturalistic inquiry.
        Sage, Beverly Hills (CA)1985
        • Melzack R
        • Wall P.
        The challenge of pain.
        2nd ed. Penquin Books, London1988
        • Margolis RB
        • Tait RC
        • Krause SJ
        A rating system for use with patient pain drawings.
        Pain. 1986; 24: 57-65
        • Melzack R.
        The McGill Pain Questionnaire: major properties and scoring methods.
        Pain. 1975; 1: 275-299
        • Melzack R.
        The short-form McGill Pain Questionnaire.
        Pain. 1987; 30: 191-197
        • Galer BS
        • Jensen MP
        Development and preliminary validation of a pain measure specific to neuropathic pain: the Neuropathic Pain Scale.
        Neurology. 1997; 48: 332-338
        • Cleeland CS
        • Ryan KM
        Pain assessment: global use of the Brief Pain Inventory.
        Ann Acad Med. 1994; 23: 129-138
        • Jensen MP
        • Turner JA
        • Romano JM
        • Strom SE
        The chronic pain coping inventory: development and preliminary validation.
        Pain. 1995; 60: 203-216
        • Loeser JD
        • Seres JL
        • Newman Jr, RJ
        Interdisciplinary multimodel management of chronic pain.
        in: 2nd ed. The management of pain in clinical practice. Lea & Febiger, Philadelphia1990: 2107-2120
        • Bothby JL
        • Thorn BE
        • Stroud MW
        • Jensen MP
        Coping with pain.
        in: Psychosocial factors in pain. Guilford Pr, New York1999: 343-359
        • Jensen MP
        • Turner JA
        • Romano JM
        • Karol P.
        Coping with chronic pain: a critical review of the literature.
        Pain. 1991; 47: 249-283
        • Williams DA
        • Thorn BE
        An empirical assessment of pain beliefs.
        Pain. 1989; 36: 351-358
        • Thorne S
        • Paterson B.
        Shifting images of chronic illness.
        Image J Nurs Sch. 1998; 30: 173-180