Savoring pleasure to relieve pain: An ecological momentary assessment study in patients with chronic low back pain.

As pain persists, individuals with chronic pain must draw upon resilience resources to improve physical function and emotional well-being. Leading theoretical models highlight positive emotions as central to the process of pain-related resilience. This ecological momentary assessment (EMA) study investigated the role of savoring-a positive emotion upregulation strategy-in the daily experience of pain among individuals with chronic low back pain (CLBP) who had not received prior training in savoring or other emotion regulation strategies. Of the 135 participants included in the study, 81 were maintained on long-term opioid therapy (LTOT), permitting further investigation of the associations between savoring and opioid analgesia. Across 14 days of EMA (3367 total observations), greater momentary savoring was concurrently and prospectively associated with lower pain severity. Momentary savoring was also associated with greater opioid analgesia, particularly when participants reported taking lower opioid doses than usual. The effects of savoring on both pain and opioid analgesia were mediated by increased positive affect. Collectively, the findings provide a mechanistic framework for how patients with chronic pain naturally utilize savoring as a positive emotion upregulation strategy to promote daily resilience to chronic pain. Future work is needed to determine which individuals are most likely to experience pain relief as a result of savoring, the circumstances in which savoring is most likely to be adopted as a pain self-management tool, and how to most efficiently and effectively intervene to promote savoring in the course of daily life with chronic pain. PERSPECTIVE: This microlongitudinal study demonstrates the naturalistic use of savoring, an emotional upregulation strategy, improves momentary and future pain severity ratings in those with chronic low back pain. Savoring was related to improved responses to opioid medication use, with increasing positive affect mediating the effects of savoring on opioid associated analgesia.