The role of Pain Resilience in the Association between Physical Activity and Pain

Studies have shown that physical activity is protective effects against the occurrence of pain complaints and its consequences, while sedentary behaviour in turn leads to disuse symptoms and result in greater pain sensitivity. It is not clear, however, which psychological variables drive this relationship. Researchers have focused considerable attention on how negative psychological factors confer increased vulnerability to pain-related distress, disability, and poor mental health, focusing in this context mainly on concepts such as kinesiophobia (fear of movement-related pain). More recently, however, positive constructs have begun to receive increasing attention as newer clinical approaches show a growing emphasis on the promotion of positive psychological and physical functioning despite ongoing pain. Resilience is one such construct, and pain resilience is the ability to maintain positive physical and emotional functioning despite pain. High levels of pain resilience have been shown to be prospectively associated with better mental and physical health among low back pain sufferers, but it is not clear if this extends to mediating the relationship between pain and physical activity. It is likely that resilient individuals are less likely to interrupt physical activity due to pain and therefore should be less affected by the negative effects of sedentariness.