How Does Chronic Pain Affect Spousal Relationships?

The burden of chronic pain affects home life between patients and their spouses, adding stress to the relationship and with up to 20% of partners saying their employment had been affected in some way.

The recently published study, appearing in the European Journal of Pain, sought to probe the extent of the impact of chronic pain in households, including not only on occupations but also chores and marital satisfaction.

Spouses provide informal caregiving for all types of illnesses and for all types of family members, and caregiving in general is known to create a great deal of stress. Most research in this area is around dementia, Alzheimer disease, Parkinson disease, and cancer; the experience of caregiving in pain settings between couples has not been explored in depth.

But like other conditions, chronic pain limits the ability to participate in daily activities and increases requests for assistance as well as heightened psychological upset.

In this study, researchers queried 114 heterosexual couples, where the person in pain was a patient at a clinic in Spain. Patients were most frequently female (59%), with a mean age of nearly 56. Spouses were majority male; only 41% of the spouses were female.

Even though a bit more than half of the spouses had chronic pain as well, the levels of intensity, interference, and disability were much lower. The most frequent pain sites for both were low back (79.8% and 30.7%, respectively), neck (46.5% and 29.8%) and knee (15.8% and 17.5%).

Results were analyzed with Pearson correlations and multivariate regression.

On average, spouses reported daily caregiving duties for a little more than 90 minutes a day, or a median of 1.57 (range, 0-4) hours.

Occupation status changed for 65.8% of patients and 27.2% of spouses. For patients, 17.5% went on permanent disability and 16.7% quit without compensation. Some retired early, and 7.0% cut the number of hours they worked.

For the 34% of patients who continued to work full time, they cut back on the amount of time they spent on household chores.

From a list of 22 household chores, patients reported a median of performing 18 before the pain began and 12 after. For spouses, they reported performing a median of 15 household chores before the pain started and 17 after.

Interestingly, the researchers wrote that only when the change in household chores were thought about by female patients was the shift dependent on gender—female patients perceived that they lost twice the number of activities as men.

Job changes for spouses included anticipating their retirement; quitting without compensatio; increasing their number of working hours, to make up for the lack of the patient’s income; or being fired as a result of juggling caregiving duties.

More patients (27.2%) than spouses (22.8%) reported having a troubled relationship, and nearly 52% of spouses reported a high to severe degree of burden.

Multivariate regression found that spouse and patient factors accounted for 37.8% of the variance of this burden. Specifically, the perception of burden was associated with patient disability (β = 0.36; P = .002); spouses’ change in occupational status (β = 0.26; P = .002); and spousal perception of marital adjustment (β = −0.36; P < .001).

Understanding these issues could lead to targeted interventions that would benefit the caregiver as well as the patient, the researchers said.

Reference

Suso-Ribera C, Yakobov E, Carriere JS, García‐Palacios A. The impact of chronic pain on patients and spouses: Consequences on occupational status, distribution of household chores and care‐giving burden. Eur J Pain. Published online June 13, 2020. doi:10.1002/ejp.1616