Effects of Partner Distress and Controlling Responses on Back Pain in Daily Life

Chronic back pain is embedded within close relationships, yet little is known about how partners' emotional and behavioral responses shape patients' daily pain experiences. This study examined whether partners' distress predicts their attempts to control (increase or decrease) the activity level of individuals with chronic back pain (ICBPs), and whether these responses are associated with worse subsequent pain outcomes the following day. One hundred forty-seven couples in which one partner had chronic back pain completed twice-daily electronic diary assessments for 30 days. The sample was older (70s), predominantly White, and well-educated. Partners reported daily pain-related distress and ICBPs reported partners' solicitousness (e.g., excessive help) and activity-related pressure. Multilevel models tested daily within- and between-couple associations and prospective next-day effects on pain severity, catastrophizing, and interference. As predicted, on days when partners experienced greater distress about ICBPs' pain, ICBPs reported more partner solicitousness (estimate =.234, SE =.037, p <.001; effect size =.799) and greater activity-related pressure (estimate =.033, SE =.017, p =.048; effect size =.524). In turn, greater partner solicitousness predicted higher pain catastrophizing (estimate =.050, SE =.021, p =.020; effect size =.098) and pain interference (estimate =.065, SE =.030, p =.028; effect size =.066) the following morning, controlling for prior-day pain outcomes. Contrary to prediction, activity-related pressure did not predict next-day pain severity, catastrophizing or interference. Partners' distress may contribute to behavioral responses in daily life, particularly excessive assistance, that inadvertently worsen pain-related functioning. PERSPECTIVE: Partners may experience emotional distress as a result of their loved one's pain. This distress may lead to behaviors that compromise the ability to cope effectively with pain. Findings highlight the interpersonal dynamics of chronic pain and suggest that interventions targeting partner distress and supportive behavior may improve pain self-management.