UBC Reports | Vol. 50 | No. 10 | Nov. 4, 2004

Coping with Chronic Arthritis Pain

New study looks at the role of social support and social strain

By Erica Smishek

Can a helping hand actually be a hindrance?

A new study by UBC psychology doctoral student Susan Holtzman examines how support networks assist or impede patients in coping with the daily pain of rheumatoid arthritis (RA). Findings of the research may lead to more effective and individualized treatment programs for RA patients as well as help educate support providers regarding optimal ways of responding to patients when they are in pain.

“Chronic pain has a ripple effect. It affects your work, social life, sex life, every part of your life,” says Holtzman, a 2003 Michael Smith Foundation for Health Research PhD Trainee. Her work is also supported by a grant from the Social Sciences and Humanities Research Council to her supervisor, Anita DeLongis.

“Many studies suggest that when people feel supported by their support network (partners, other family members, friends, colleagues, etc.), they’re more adapted, less stressed,” she says. “With chronic pain, it’s more complicated -- that support can be helpful or it can be harmful.

“If a patient has a very attentive spouse, who wants to do everything for them, it can be difficult. Particularly among the elderly, being independent is very important. Support providers want to help them, but the emotional impact can actually be quite negative and effect your belief of what you can do for yourself.”

Rheumatoid arthritis (RA) causes inflammation in the lining of the joints and/or other internal organs. The often-disfiguring disease can impede a person’s functional ability to a point where they cannot even turn on a faucet. RA affects 300,000 (1 in 100) Canadians.

“With no cure for rheumatoid arthritis, anything we can do to improve people’s quality of life is key,” says Holtzman.

With no existing cure or prevention, current treatments attempt to relieve pain, stiffness and lack of mobility. They include drugs, exercise, joint protection and lifestyle changes, and surgery.

“We’re looking at the types of support patients receive and how this support influences their ways of dealing with the pain,” Holtzman explains. “We are also interested in determining the types of people that benefit the most and the least from various types of support, and how we can advise patients support networks.”

In collaboration with the Mary Pack Arthritis Program in Vancouver, she is recruiting 100 RA patients and their partners who reside in B.C. but outside the Lower Mainland. She uses questionnaires, daily telephone check-ins and daily records used by the patients to track pain levels, disability, mood, types of support received, satisfaction with support, coping strategies and health.

“Rheumatoid arthritis is very unpredictable. Patients don’t know from day to day how they will be feeling,” Holtzman says.

“We can’t just hand out a one-time questionnaire and get an accurate picture. We need to measure daily to really determine what is going on.”

The study looks both at what the spouse says they have done to support the patient and how the patient interprets that support. It considers such factors as the patient’s personality and whether the patient’s marriage is a healthy one.

Data collection for the study will continue through January. Holtzman anticipates results by May.