The American College of Lifestyle Medicine identifies social connection as one of the essential pillars of therapeutic lifestyle interventions for treating chronic conditions. This pillar, alongside others such as nutrition, physical activity, stress management, restorative sleep, and the avoidance of risky substances like tobacco and alcohol, plays a crucial role in promoting health. Social connection involves meaningful relationships and a sense of community, significantly impacting physical, mental, and emotional health. Research demonstrates that strong social connections can reduce stress, enhance immune function, and improve outcomes for conditions such as heart disease, diabetes, and depression.
Integrating social support into treatment plans fosters a holistic approach that addresses both the biological aspects of chronic diseases and the emotional and psychological well-being of patients. This multidimensional strategy acknowledges that health is influenced by a complex interplay of physical, mental, and social factors. Forms of social support include support groups, family involvement, community programs, and therapeutic relationships with healthcare providers. These elements help patients develop coping strategies, adhere to treatment regimens, and remain motivated. Additionally, fostering robust social networks can alleviate feelings of isolation and anxiety, common in chronic illness. By creating a supportive environment, healthcare providers can enhance patient resilience, promote healthier lifestyle choices, and ultimately improve clinical outcomes. Integrating social connection into interventions promotes a comprehensive strategy that enhances overall quality of life and facilitates better disease management.
In the context of chronic pain, higher levels of perceived social support are associated with decreased pain intensity, depression, and better coping strategies. Supportive social networks encourage effective coping mechanisms, aiding individuals in managing pain severity more effectively. Social support can include the assistance of caregivers who help patients maintain autonomy and a sense of connection. Furthermore, social support can improve both physical and psychological health in chronic pain patients and buffer the negative effects of stress on health outcomes. It acts as a shield against the adverse impact of perceived injustice on pain interference, suggesting that a strong social network can help individuals navigate the challenges associated with chronic pain, potentially reducing pain interference in daily life. However, not all social support is beneficial; solicitous responses from spouses or partners that encourage reduced activity can lead to poorer physical function, despite potentially improving psychological function.
In summary, incorporating social support strategies into chronic pain management is crucial for improving treatment adherence, reducing disability levels, and enhancing overall outcomes. Educating chronic pain patients on accessing the most useful types of social support, versus conditional/pain-contingent support, can enhance long-term positive outcome. A multidisciplinary approach combining emotional, tangible, informational, and appraisal support from a strong social network is most effective in reducing chronic pain severity and improving overall well-being.
Anneleen Malfliet
Assistant professor at Vrije Universiteit Brussel, Belgium. Senior postdoctoral researcher funded by the Research Foundation Flanders.
2024Pain in Motion
References and further reading:
Castarlenas, E., Galán, S., Solé, E. et al. Perceived Stress, Perceived Social Support, and Global Health in Adults with Chronic Pain. Int.J. Behav. Med. (2023). https://doi.org/10.1007/s12529-023-10250-6
McMurtry, M., Viswanath, O., Cernich, M. et al. The Impact of the Quantity and Quality of Social Support on Patients with Chronic Pain. Curr Pain Headache Rep 24, 72 (2020). https://doi.org/10.1007/s11916-020-00906-3
de Matos, M. O., & Bernardes, S. F. (2023). Helpful social support for chronic pain in long-term care residents: “With a little help I manage on my own”. Nursing Open, 10, 6326–6335. https://doi.org/10.1002/nop2.1881
Oraison HM, Kennedy GA. The effect of social support in chronic back pain: number of treatment sessions and reported level of disability. Disabil Rehabil. 2021 Jun;43(11):1526-1531. doi: 10.1080/09638288.2019.1668969.
Alicia E. López-Martínez, Rosa Esteve-Zarazaga, Carmen Ramírez-Maestre. Perceived Social Support and Coping Responses Are Independent Variables Explaining Pain Adjustment Among Chronic Pain Patients. The Journal of Pain, 9,4 (2008). https://doi.org/10.1016/j.jpain.2007.12.002.
Xianwei Che, Robin Cash, Paul Fitzgerald, Bernadette M. Fitzgibbon. The Social Regulation of Pain: Autonomic and Neurophysiological Changes Associated With Perceived Threat. The Journal of Pain, 19, 5 (2018). https://doi.org/10.1016/j.jpain.2017.12.007.
Penn TM, Trost Z, Parker R, Wagner WP, Owens MA, Gonzalez CE, White DM, Merlin JS, Goodin BR. Social support buffers the negative influence of perceived injustice on pain interference in people living with HIV and chronic pain. Pain Rep. 2019 Mar 14;4(2):e710. doi: 10.1097/PR9.0000000000000710.
Holtzman S, Newth S, Delongis A. The Role of Social Support in Coping with Daily Pain among Patients with Rheumatoid Arthritis. Journal of Health Psychology. 2004;9(5):677-695. doi:10.1177/1359105304045381
