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My husband has had chronic back pain for the last five years. I'm trying to figure out if being sympathetic is helpful or making things worse. Should I express concern or ignore him when he makes signs like he is in pain?

When one spouse hurts, the other spouse is usually acutely aware of it. Having the understanding and support of a loved one can help us through painful conditions. When the pain lasts longer than expected, how do partners cope? What happens when the problem becomes chronic or even permanent? And what is the effect on the relationship? These are all important questions that social scientists are exploring. In a recent study from Canada, researchers looked at the degree to which a partner's sensitivity to a hurting spouse affected the marriage. They looked at the supportive spouse's sensitivity to changes in pain and disability in their pained partner. Being able to gauge your spouse or partner's pain level is referred to as empathic accuracy. The researchers said there were no differences between men and women in their sensitivity toward their partner's pain. They did find several factors that influenced empathic accuracy. These included the pain patient's facial and body expressions of pain, level of catastrophic thinking, and fear of reinjury. The supportive spouses own level of pain catastrophizing was evaluated but it was not considered a contributing factor. The also reported that patients in pain had worse outcomes when their spouse was aware of the patient's pain. It appeared that patients with disabling pain showed more outward signs to alert their spouse of their pain. Most spouses were able to accurately estimate the partners' pain during the lifting tasks. Less empathic spouses were more likely to ignore the pain partner and express anger, frustration, or irritation toward them. There have been some other experts who suggest ignoring a spouses' pain or inaccurately assessing pain may be a way to protect the relationship. Having a highly empathic spouse was not an advantage. Patients with chronic pain whose spouse was in tune with their pain had lower function, less social activity, and worse outcomes. The authors conclude that it's not necessary to have an accurate idea of a spouse's pain to have a happy marital relationship.

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