This study examines the associations between coping strategies and adjustment to chronic musculoskeletal pain in a sample of Portuguese patients and compares these findings with those from two studies using patients from the USA. The study used Portuguese translations of the Coping Strategies Questionnaire (CSQ) and Chronic Pain Coping Inventory (CPCI) to assess coping responses and measures of pain intensity, pain interference, and depression. Results showed statistically significant positive associations between patient dysfunction and certain coping strategies, such as catastrophizing, praying/hoping, guarding, asking for assistance, and support seeking. Negative associations were found between the criterion measures and ignoring sensations, coping self-statements, and increasing behavioral activities. Mean differences were found between the Portuguese and USA samples in nine of the 15 coping scales. The findings support the reliability and validity of the translated measures and indicate both similarities and differences in coping strategies between the two cultures, suggesting cultural differences in how people cope with pain. The study highlights the importance of adapting pain treatment programs to different cultural contexts.This study examines the associations between coping strategies and adjustment to chronic musculoskeletal pain in a sample of Portuguese patients and compares these findings with those from two studies using patients from the USA. The study used Portuguese translations of the Coping Strategies Questionnaire (CSQ) and Chronic Pain Coping Inventory (CPCI) to assess coping responses and measures of pain intensity, pain interference, and depression. Results showed statistically significant positive associations between patient dysfunction and certain coping strategies, such as catastrophizing, praying/hoping, guarding, asking for assistance, and support seeking. Negative associations were found between the criterion measures and ignoring sensations, coping self-statements, and increasing behavioral activities. Mean differences were found between the Portuguese and USA samples in nine of the 15 coping scales. The findings support the reliability and validity of the translated measures and indicate both similarities and differences in coping strategies between the two cultures, suggesting cultural differences in how people cope with pain. The study highlights the importance of adapting pain treatment programs to different cultural contexts.