Background Chronic pain is a leading cause of disability globally and is challenging to manage; self-management is of growing interest, alongside social prescribing. Sociocultural and individual differences exist both in the experience and reporting of pain, and in the use and effectiveness of self-management strategies. This study aims to explore the interaction between chronic pain, its self-management, and ethnicity and deprivation.

Methods A qualitative secondary analysis was performed of two datasets: fifteen interviews with South Asian adults in West Yorkshire (2020) with patient or family caregiver experience of chronic pain; and three focus groups of fifteen White British adults with chronic pain from different socioeconomic strata of Glasgow (2008). Participants consented to secondary analysis. Two analysts (ST, AR) used theoretical thematic analysis underpinned by a phenomenological approach. Two PPI contributors guided analysis and interpretation.

Results Participants described learning to live alongside chronic pain through a long process of acceptance and lifestyle modification. The latter included adoption of self-management strategies such as exercise, use of alternative therapies, and modifications such as housing adaptation which were challenging for participants in financial difficulty. For most participants, coping with pain was more affected by personality than by protected characteristics, though female South Asian participants perceived a cultural expectation to carry on despite pain. Medication-related concerns were prevalent, especially amongst South Asian participants, but were mitigated by involvement in decision-making.

Conclusions Participants adopted self-management strategies despite describing no formal training in this in; access to and choice of strategies were influenced by sociocultural factors including financial means and perceived social acceptability. Retaining a sense of self-determination was important, and was facilitated by shared decision-making around medications, follow up and referral; active self-management strategies such as exercise; and engagement with alternative therapies.