Coping with chronic pain during exposure to pain produced by activity was examined in 30 patients with chronic low back pain referred to a university pain management center. Patients' range of motion, autonomic responses, and anticipatory anxiety ratings before exposure and ratings of pain and anxiety after exposure were assessed, and the number of repetitions of the activities that produced the pain was recorded. Analyses showed that using coping self-statements was associated with lower skin conductance during anticipation and greater range of motion. Praying, hoping, and catastrophizing were associated with greater anticipatory anxiety, greater anxiety during the painful activity, and less range of motion from the onset of increased pain to the point of pain tolerance. Praying and hoping were associated with higher pain ratings and fewer repetitions of the activity. Assessment of coping during an incident of pain and multiple methods to measure pain and distress provided convincing evidence that patients' self-management responses influence the consequences of pain exposure.