Psychosocial Adjustment and Multi-dimensional Coping in Working Individuals with Chronic Musculoskeletal Pain: An Interpretative Phenomenological Study
DOI:
https://doi.org/10.52053/jpap.v7i1.460Keywords:
Biopsychosocial Model of Pain, Chronic Nonspecific Musculoskeletal Pain, Coping, Interpretative Phenomenological Analysis, Pakistan, Psychological Well-beingAbstract
Chronic nonspecific musculoskeletal pain (CNMP) is a global health condition that affects psychological well-being, social functioning, and work performance of the working individuals. Despite the quantitative evidences on psychosocial correlates, a little qualitative research explored that how working individuals cope with CNMP within South Asian sociocultural contexts. The aim of the study was to explore the lived experiences of working individuals with CNMP about coping mechanisms focusing on psychosocial and emotional reactions associated with chronic pain. Purposive sampling technique was used to collect information about the coping strategies used to deal with CNMP and associated psychosocial reactions through semi-structured interviews from 14 working individuals (7 men, 7 women) with CNMP aged 29–45 years. Interpretative Phenomenological Analysis (IPA) was used to analyze transcripts and reflexivity, triangulation, member checking, and an audit trial were used to ensure rigor of the study. Coping had emerged as a dynamic biopsychosocial–spiritual process involving behavioral, cognitive, emotional, social, and spiritual strategies. Participants relied on emotion regulation, family support, and faith to sustain functioning and cultural values of endurance also contributed to emotional suppression and limited help-seeking. Coping with CNMP extended beyond the management of symptom and included psychological, relational, and spiritual adaptation for improving adjustment and well-being among working individuals with CNMP. A holistic and culturally responsive intervention integrating psychological care, workplace support, family involvement, and spirituality is essential.
References
Ahmed, H., Saeed, M. A., & Attique, F. (2024). The burden of musculoskeletal pain, associated sociodemographic factors, and disability in Pakistan. International Journal of Rheumatic Diseases, 27(1), e14972. https://doi.org/10.1111/1756-185X.14972
Alhashim, A. A. (2025). Work-Related Musculoskeletal Disorders and Their Impact on Quality of Life: A Comprehensive Review. Saudi Journal of Medical and Pharmaceutical Sciences, 11(5), 360-377. https://doi.org/10.36348/sjmps.2025.v11i05.002
American Psychological Association. (2017). Ethical principles of psychologists and code of conduct (2002, Amended effective June 1, 2010, and January 1, 2017). https://www.apa.org/ethics/code
Amjad, M. A., Siddiqui, A. M., Bashir, K., Ghafoor, A. U., & Durrani, R. S. (2023). Prevalence of chronic pain in Pakistan - a national survey. JPMA. The Journal of the Pakistan Medical Association, 73(6), 1217–1220. https://doi.org/10.47391/JPMA.6671
Basharat, A., Qamar, M. M., Nasir, S., & Faraz, K. (2022). Prevalence of chronic non-specific musculoskeletal pain in household females, and its impact on their quality of life. Pakistan Journal of Rehabilitation, 11(1), 43-50. https://ojs.zu.edu.pk/pjr/article/view/1329
Bashir, M., Saleem, T., & Arouj, K. (2025). Religiously Integrated Forgiveness Therapy: A Psychotherapeutic Tool for Depression and Pain Among Pakistani Patients with Chronic Widespread Pain. Journal of Religion and Health, 64(3), 2136-2151. https://doi.org/10.1007/s10943-024-02179-1
Carcary, M. (2020). The research audit trail: Methodological guidance for application in practice. Electronic Journal of Business Research Methods, 18(2), 166-177. https://doi.org/10.34190/JBRM.18.2.008
Ferreira-Valente, A., Queiroz-Garcia, I., Pais-Ribeiro, J., & Jensen, M. P. (2020). Pain diagnosis, pain coping, and function in individuals with chronic musculoskeletal pain. Journal of Pain Research, 13, 783-794. https://doi.org/10.2147/JPR.S236157
Ghanei-Gheshlagh, R., Mukhtar, M., Asmat, K., & Sharafi, S. (2025). The silent strain: a systematic review and meta-analysis on the prevalence of occupational stress among Pakistani nurses. BMC Nursing, 24(1), 347. https://doi.org/10.1186/s12912-025-02985-2
Harte, N., Aaron, R. V., Bhattiprolu, K., Bisby, M. A., Gandy, M., Hathway, T., Dear, B.F., & Dudeney, J. (2024). The association between anxiety and depression symptoms and pain and function in adolescents and young adults with chronic pain: A meta-analysis. Journal of Psychosomatic Research, 187, 111945. https://doi.org/10.1016/j.jpsychores.2024.111945
Joshi, G. (2025). A Phenomenological Exploration of Identity Development in Adolescents with Chronic Pain (Doctoral dissertation, University of East London). https://doi.org/10.15123/uel.8yvwx
Kelsey, C. M., Fasman, A., Quigley, K., Dickerson, K., Enlow, M. B., & Nelson, C. A. (2024). Context?dependent approach and avoidance behavioral profiles as predictors of psychopathology. Developmental Science, 27(3), e13469. https://doi.org/10.1111/desc.13469
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer publishing company.
Lee, K. C., Haines, S., Gable, K. N., Bruce, S. P., Kostrzewa, A., Mantione, M. M., Oliphant, C., Richter, S.K., Wende, H.M., Burrell, A.A., & Gordy, X. Z. (2025). Exploration of psychosocial hazards: job demands, rewards and recognitions and autonomy to address workforce well-being. American Journal of Pharmaceutical Education, 89(8), 101459. https://doi.org/10.1016/j.ajpe.2025.101459
Lincoln, Y., & Guba, E. G. (1985). Naturalistic inquiry. Newbury Park, CA: Sage.
Malik, M., Rehman, H., Hussain, A., Hashmi, A., Al-Sunaidar, K. A., Balogh, G., Gajdács, M., & Jamshed, S. (2025). Psychological Burden and Coping Strategies Among Pakistani Adults: A Cross-Sectional Survey Study. Epidemiologia, 6(3), 30. https://doi.org/10.3390/epidemiologia6030030
Martínez-Borba, V., Ripoll-Server, P., Yakobov, E., & Suso-Ribera, C. (2021). Predicting the physical and mental health status of individuals with chronic musculoskeletal pain from a biopsychosocial perspective: a multivariate approach. The Clinical Journal of Pain, 37(3), 211-218. https://doi.org/10.1097/AJP.0000000000000913
Martinez-Calderon, J., Matias-Soto, J., & Luque-Suarez, A. (2022). “My Pain Is Unbearable… I Cannot Recognize Myself!” Emotions, Cognitions, and Behaviors of People Living With Musculoskeletal Disorders: An Umbrella Review. Journal of Orthopaedic & Sports Physical Therapy, 52(5), 243-A102. https://www.jospt.org/doi/10.2519/jospt.2022.10707
McMillan, J., & Soundy, A. (2024). The development of a model considering hope, uncertainty emotion regulation in people with chronic low back pain: A worked example of a social constructivist meta-ethnography study [Preprint]. Preprints.org. https://doi.org/10.20944/preprints202411.0137.v1
Memon, R., Khaliq, A., Ranieri, V., Asif, M., Bhatti, M. M., Khan, B. A., Chaudhry, N., Chaudhry, I. B., Hussain, N., & Edwards, S. J. (2024). An examination of the relationship between risk perceptions, cultural-religious beliefs and coping during COVID-19 pandemic control in South Asian countries: a systematic review. BMC Psychology, 12(1), 461. https://doi.org/10.1186/s40359-024-01963-8
Nicholas, M., Vlaeyen, J. W., Rief, W., Barke, A., Aziz, Q., Benoliel, R., Cohen, M., Evers, S., Giamberardino, M. A., Goebel, A., Korwisi, B., Perrot, S., Svensson, P., Wang, S. J., & Treede, R.-D. (2019). The IASP classification of chronic pain for ICD-11: Chronic primary pain. Pain, 160(1), 28–37. https://doi.org/10.1097/j.pain.0000000000001390
Nizza, I. E., Farr, J., & Smith, J. A. (2021). Achieving excellence in interpretative phenomenological analysis (IPA): Four markers of high quality. Qualitative Research in Psychology, 18(3), 369–386. https://doi.org/10.1080/14780887.2020.1854404
Olmos-Vega, F. M., Stalmeijer, R. E., Varpio, L., & Kahlke, R. (2023). A practical guide to reflexivity in qualitative research: AMEE Guide No. 149. Medical Teacher, 45(3), 241-251. https://doi.org/10.1080/0142159X.2022.2057287
Oluka, A. (2025) Phenomenological Research Strategy: Descriptive and Interpretive Approaches. F1000Research, 14 725. https://doi.org/10.12688/f1000research.166273.1
Pakistan Medical Commission. (2022). Pakistan Medical and Dental Council Act, 2022. Retrieved from https://pakistancode.gov.pk
Petrucci, G., Papalia, G. F., Russo, F., Vadalà, G., Piredda, M., De Marinis, M. G., Papalia, R., & Denaro, V. (2021). Psychological approaches for the integrative care of chronic low back pain: a systematic review and metanalysis. International Journal of Environmental Research and Public Health, 19(1), 60. https://doi.org/10.3390/ijerph19010060
Rogers, A. H., & Farris, S. G. (2022). A meta?analysis of the associations of elements of the fear?avoidance model of chronic pain with negative affect, depression, anxiety, pain?related disability and pain intensity. European Journal of Pain, 26(8), 1611-1635. https://doi.org/10.1002/ejp.1994
Sadriwala, K. F., & Malik, M. (2021). Occupational Stress, Coping Strategies, and the Impact of Culture in the Middle East: A Systematic Review of Evidence from Oman. Organizational Stress Around the World, (194-220). Taylor & Francis Group. https://doi.org/10.4324/9780429292538
Shah, R. U., Qureshi, U. Z., Ali, A., Khan, Z. Z., & Ansar, W. (2025). Prevalence of Musculoskeletal Pain and Its Relation with Disability Risk Factors in Abbottabad Population: A Cross-Sectional Study. The Healer Journal of Physiotherapy and Rehabilitation Sciences, 5(1), 249-255. https://doi.org/10.55735/xk6ddk44
Smith, J. A., & Osborn, M. (2015). Interpretative phenomenological analysis as a useful methodology for research on the lived experience of pain. British Journal of Pain, 9(1), 41–42. https://doi.org/10.1177/2049463714541642
Vishwakarma, V. K. (2023). Translating cultural nuances: Challenges and strategies. ELT Voices, 13(2), 8268531. https://doi.org/10.5281/ZENODO.8268531
Vlaeyen, J. W. S., Maher, C. G., Wiech, K., Van Zundert, J., Meloto, C. B., Diatchenko, L., Battié, M. C., Goossens, M., Koes, B., & Linton, S. J. (2018). Low back pain. Nature Reviews. Disease primers, 4(1), 52. https://doi.org/10.1038/s41572-018-0052-1
Williams, C. C., Owen, L. L., Gunsilius, C., Nassar, M. R., & Petzschner, F. H. (2025). Altered Decision-Making Across Acute and Chronic Pain States: A Bias Towards Context-Dependent Valuations. bioRxiv, 2025-07. https://doi.org/10.1101/2025.07.09.663993
Williams, S. (2020). The experience of co-morbidity: an interpretative phenomenological analysis: living with chronic pain and traumatic stress (Doctoral dissertation, Middlesex University/Metanoia Institute). https://mirep.metanoia.ac.uk/id/eprint/245
World Health Organization. (2023). Musculoskeletal health. Retrieved from https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2026 Nazia Zafar, Sayyeda Taskeen Zahra, Sadia Saleem

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) License: This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International License (https://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-Commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the Journal website at (https://iprpk.com/ojs/index.php/jpap)






