Managing pain when life gets challenging.
The number one thing that people in pain struggle with the most.
Without doubt, one of the hardest things to do on your own is to navigate the maze that is chronic or persistent pain.
If you are someone who is on that path, you’ll know that an explosive flare up is to be avoided but you may not really know what causes this to happen. So you tip toe through your days and weeks, mindful and fearful of anything that even gives you a sniff of potentially being problematic.
You’ll also know that you might not really know the best strategy for you to minimise or even fully overcome your painful symptoms. That’s often because you are getting conflicting information from each person you visit in a healthcare setting and from each person you speak to about your symptoms.
Even if you are experienced enough or lucky enough to understand the triggers for a flare up and you have a solid plan in place to help you make progress and self manage towards recovery - that might still not be enough….
Life has a funny way of throwing challenges and diversions into our path, just when we seem like we need them the least.
These challenges may come in the form of an illness or an external stressor. You might have a loved one that gets injured and you have to help care for them. Your job may become under threat due to the current economic climate and your financial future is less than certain. Your sleep may suffer due to problems that you might not understand fully and your recovery levels drop as a result.
These are just a flavour of the myriad of potential things that can cause you to fall off the wagon when it comes to making progress with your symptoms.
All of which make it more difficult for you to maintain or search for progress.
This is a likely contributing factor to failed treatments, lower adherence to rehabilitation plans, more reliance on medications and less ability to self-manage. Is it any wonder that the burden of chronic pain globally is increasing?
As a society and as a collection of healthcare professionals, it is incumbent upon us to figure out structures or strategies to assist a person in pain in dealing with this.
It’s Normal.
Sitting down to write this post, my first intention is to raise some awareness for a person in pain. To hopefully validate for you that this is common.
It is completely normal for rehab exercises, sleep hygiene practices, mindfulness practices, exercise classes, appointments with healthcare practitioners and more to get thrown straight out of the nearest window when the sh*t hits the fan in your life.
I also know, having had conversations about this topic with a high percentage of clients, that at some point in their journey to overcome symptoms they will experience this. EVERY CLIENT that I have spoke to about this feels guilty about forgetting to do their homework or about cancelling an appointment or seemingly messing up the progress they have made by returning to older unhelpful habits.
They also often mention that they become entirely self critical about their behaviour when the sh*t has hit the fan.
“Ah my bloody exercises, I’ve not done them in a week and I can feel my back tightening up again. It had been so good. I’m such a _____.”
Internal conversations like this offer very little scope for the wider picture.
Change is difficult.
Sustaining change in the face of mounting stressors, internal and external demands on your time, focus and energy is even more difficult.
And that is normal and to be expected.
Diversions to the optimal path are expected (at least from my side when working with someone in pain). Planning for perfect is the perfect way for a plan to fail.
Instead, my focus when communicating with clients about this is to expect stuff like this to make it more difficult. If it doesn’t happen, happy days :)
If it does happen, it has already been spoken about (or written about in this case) and hopefully normalised as part of the process. If that reduces or stops the negative mental chatter that happens when we lose our way, its worth writing about and speaking about in my opinion.
Less negative mental chatter and consequentially less negative emotion hopefully lead to less barriers to getting back on track. If by reading this, you can resist the temptation to push the F**K IT button and exit the path of progress entirely, it’s worth it.
So what might help when a diversion like this occurs in life?
Never miss twice.
This strategy is one that is often really helpful. If all hell is breaking loose in your life and you are just about treading water, aim to never miss twice.
If this week has been woeful for you in taking actions that you know will help you, chalk it off as one of those weeks that can happen. Aim to get back on track next week so that you never miss two weeks in a row.
Even if you again fall off the path in a few weeks time, never miss twice. Aim to get back on track the following week to the best of your ability. It gives space for everything to fall apart for a while and for that to be ok.
Clients have mentioned that his has reverberated around inside their cranium and been helpful in reframing the chaos that can sometimes occur. In the bigger picture, one week of not following your plan will not matter if you can string sequences of good weeks together over a longer period of time.
The trend is always more important than the individual event for longer term progress.
Consider an Accountability buddy.
Having someone in your life to be a dedicated accountability partner might be exactly the solution that you need. Someone who you give permission to check in with you at defined time points. To help you to remain accountable.
Some clients add incentives to this strategy and give themselves forfeits or fines to pay when they fail to meet the standard that they want to.
This can sometimes gamify the challenge and make it more enjoyable. (For others this approach isn’t enjoyable at all).
Perhaps a friend or colleague that is also struggling with pain might be a useful companion here as you share what can be a lonely journey at times. Someone who gets what it can be like to struggle with pain.
Again, this might not be for you and that’s ok. It is offered here as an option to consider for you.
Conversation with your loved ones / Health Care Professional
Following on from an accountability buddy is a simple conversation. You might not need someone to hold you accountable. You may benefit greatly from someone to listen. Someone to help you navigate the chaos when it erupts.
Someone to have your back and to support you when it gets difficult. It’s amazing when clients share with me that instead of bottling it all up, they spoke with their significant other, they told their GP or physio how they were feeling. And that it led to a really productive conversation where they felt heard, validated and supported.
Sometimes that is the difference when you are going through a flare up and are struggling to manage.
Strive for progress not perfection
Whenever I have fallen off the path and my progress is at a halt, it generally brings up those perfectionist type of thoughts that are so unhelpful.
“You’ll never get there if you don’t get all of your exercises done”.
“There’s no point in half doing this, you told yourself you weren’t going to mess this up this time” etc etc etc.
The simple fact is that getting back on the path is what is realistic. Perfection is impossible to achieve and only brings up negative emotion and self criticism.
Aim to get back on the path, even if it’s not at the desired level and build some momentum again. As I mentioned above, the trend is more important than the event.
5 minutes of exercises or self regulation practices may not seem like a lot.
5 mins x 5 days per week = 21.5 hours of work on yourself over a 12 month period - that is significant!
Wrapping up
It’s a challenge to overcome pain. Life can be challenging at times. Recognising that it’s ok for the optimal or ideal plan to change when life becomes less routine and more chaotic is the first step in keeping the trend of improvement going over the long term. Avoid the boom and bust cycle where possible and aim to employ some strategies that will help you when times are tough.
If this resonated with you, I’d love if you could take a moment of your time to share this post with someone who would benefit from reading it.
David