Persistent pain negatively impacts upon the individual suffering this condition. Almost all care related to persistent pain is self-managed. Decision-making is a critical skill of the self-manager and without these skills it would be improbable that effective self-management would emerge. However, current theories regarding decision-making and self-management have not adequately accounted for the many difficulties faced by individuals enduring persistent pain and the consequences of these experiences for the decision-maker. This Grounded Theory study revealed that individuals will transform into three distinct types of decision-makers using three different styles of decision-making in response to the many and varied problems related to the experience of persistent pain. These findings will provide nurses with valuable information to better equip individuals with persistent pain through the decision-making processes necessary for successful self-management.