I can suppress the pain, but then what? : seeking resolution to chronic musculoskeletal pain among immigrants from China

Chronic musculoskeletal pain is a common problem among working aged adults (McIntosh & Hall, 2007). It reduces quality of life, is challenging to diagnose and treat, and incurs a significant economic burden on society (Woolf & Pfleger, 2003). Evidence indicates that one’s cultural background has major relevance in their pain experience and associated coping behaviours (Gatchel et al., 2007). To date, studies investigating cultural influences in musculoskeletal pain have primarily taken a deductive and quantitative approach in accessing culture, which can limit the researcher from acquiring a rich and contextualized picture of an ethnic culture (Waldram, 2006). The current study aims to construct knowledge about a large but under-researched ethnic minority group in Canada—immigrants from mainland China—using Constructivist Grounded Theory (Charmaz, 2006), a methodology that allows for the accessing of cultures in a contextualized and naturalistic form. Twenty-four first-generation immigrants from mainland China living in Metro Vancouver, Canada, with chronic musculoskeletal pain were interviewed about their pain management experiences. Through theoretical sampling, coding, writing and sorting memos, and diagramming, concepts were constructed and formed into a theoretical framework explaining how immigrants from China (ICs) manage chronic musculoskeletal pain. Results indicate that ICs try to resolve their pain by being cautious (i.e., opting for low-risk methods), self-reliant (i.e., handling the pain on one’s own), proactive (i.e., actively seeking information and solutions), and critical (i.e., evaluating medical opinions, recommendations, and services). Those with mild pain self-manage using mainly cautious and self-reliant approaches, whereas those with severe pain also use proactive and critical approaches. These approaches are informed by underlying pain-related beliefs (e.g., that medications are toxic), moral values (e.g., one ought to face pain courageously), and memories of accessing healthcare in China. Furthermore, results suggest that ICs, over time, develop experiences and insights about pain management, forming an attitude of self-efficacy and pain acceptance. To evaluate the level of contribution of current results to the field, key findings of the study were compared with what is known in the extant literature. The study’s possible contributions to the pain management literature, potential utility for practitioners, and methodological limitations are discussed.Education, Faculty ofEducational and Counselling Psychology, and Special Education (ECPS), Department ofGraduat