One of the quickest ways to get knocked off track when it comes to your fitness goals is a pain flare. This is especially true for those that deal with chronic pain. Whether it is chronic low back pain, sciatica, fibromyalgia, and even neck pain or an old shoulder injury, many struggle with knowing where to start. Should you stretch? Should you strengthen? No pain, no gain? Avoid it? Keep resting it?
So, what makes pain flare?
First, a bit about what pain is. When somebody is dealing with persistent or chronic pain, often the smallest things can cause a flare-up. Anything from just going for a walk, taking a light yoga or Pilates class, or even simply cleaning the house can lead to days of agony. Time lost at work, time lost with family, and definitely time lost at the gym. This restarts the boom-bust cycle that everyone with chronic pain knows about. The “I’m having a good day so I must try to take care of everything on the to do list” followed by a predictable crash. This is doubly difficult when wanting to exercise. So, why do these activities flare your pain? The answer is not what you might think. It is not likely to be a fresh injury or a reinjury of something that happened before. This is especially true when you are months if not years out from that injury. So, why does it hurt? Your body was built with an amazing alarm system designed to keep you safe. Its called your nervous system and it has roughly 45 miles of those nerves all throughout your body. It is also equipped with a bunch of danger detectors that let your body know when it needs to pay attention to an area. The problem with these danger detectors is that they become more sensitive after an injury and sometimes they get stuck on overprotective(i.e. Pain that happens when no additional damage happens). Plus, these danger detectors have special sensors that can be triggered by things such as change in temperature(This is why storms or cold fronts can increase your pain), stress or sleeplessness can trigger it, it can be triggered by your immune system(especially with pneumonia or the flu), and it can be triggered by pressure(trouble finding a comfortable position, this is why). Plus, the longer pain has gone on, your body puts more sensors into the alarm. This works like a sticky keyboard, you hit one key but get 5 of the same letter on the screen. This can create pain with seemingly little activity or effort. So, with an alarm system set to overprotective, it is a little bit easier tosee how even light activities can trigger pain, especially when so many other things can set off pain. It can seem that there is no hope when things have gotten that bad. But, the good news is that chronic pain can be walked back. A stuck on alarm system can be “reprogrammed” but it takes time.
How to begin easing chronic pain with activity.
First, grab a pen and paper because we need to map out how much you can do before you have a flare. Don’t skip this step. Once you understand how much you can do before you have a flare, then you can begin planning your activity around it. Let's take walking for an example. You notice that you can only walk 15 minutes before you notice your pain getting worse. Before then, you were OK. But your goal is 30 minutes, so you usually push through to get your steps in and suffer the consequences(and sometimes days off because of pain). So, if you notice that you begin to get worse after 15 minutes, know this, you are very likely not injuring yourself but your alarm system is being triggered by the amount of time you are moving. So, we then do our exercise at a level below what usually triggers it. That’s either stopping just before it consistently gets worse(so in this case, you may walk 10-13 minutes then take a break). This break can be just long enough for you to then do another 10 minutes(without triggering) or it can mean a walking session in the morning and then another later in the day. That’s OK, it still counts.
Second-go back to your pen and paper map of what causes a flare. If stuff at work or home flares your pain, mark how much you can do before you have a flare. If your job has different duties and you are able to switch between them, then set a timer to do that(don’t wait until the pain is bad enough to force you to change). If you are taking care of the house, you can do the same map. Let’s say that if you try to vacuum or sweep the whole house at a go and you are laid up after, chances are your body was telling you so. So, once you know what it takes to flare we then divide your house up. Even if the size you are working on seems small, this will make a massive difference in how you feel. Let’s say you have 5 rooms but the living room is massive plus 2 bathrooms. Now, you notice that if you try to do the living rooms and the bathrooms in the same day, you are laid up or it flares your pain. But you notice that your pain begins halfway through the living room.Your plan is to divide the things that make it worse in the living room and tackle part of those one day and part the next. Say it is vacuuming the living room. Set a boundary and vacuum that portion(the amount before your pain flares) and then stop(I can already hear you wanting to yell at me …but stick with me here, your body will thank you). Once you’ve done that half, go do something that relaxes you(you can come back to the other half later…I won’t tell). Now, you may be able to finish that the same day or it may be the next, either way, give yourself some grace, this will improve. Map the same out for the rest of the house.
Third Then map out what your “perfect day” looks like. This is the kind of day that if somebody waved a magic wand over you and everything was better kind of day. What would you do? Now, lets find which one of those “wins” from your perfect day would make you feel good about an average day.
Now, of those 3, what one or two absolutely must happen on a “bad day”? These are the ones that would make you feel bad if they didn’t get done or that it was a completely lost day(Example, making the bed) Now, these days have to be re-evaluated probably monthly because if you stick to them, you’ll find that you are able to do more because you’ve found what wins are the most valuable for you(try to make sure that getting 5 minutes of outdoors activity is part of it-trust me, you’ll feel better just being outside). The key here is if you keep track, you’ll often find that you are able to do more week in and week out because you’re avoiding the boom-bust cycle of chronic pain.
Does making this roadmap seem like only wishful thinking? Confused about where to start? Book a call from the comfort of your home or office and on your schedule with one of our Chronic Pain Specialists. You can schedule your call here. Need help now? Come by and talk with one of our Doctors of Physical Therapy at no charge. We offer FREE consultations, which give you the opportunity to come in and meet us and see for yourself how we can help you.
Here are just a few of the things you will learn in one of our free consultation:
What is the underlying cause of your pain? (hopefully nothing too serious!)
Roughly, how long will it take to fix the problem?
What to do to help – which doesn’t include painkillers, resting or surgery etc.
What other, natural, drug free methods are there to speed up recovery alongside treatment?
Our consultations are great for anyone that may be “unsure” if physio is right for them, and they give you the opportunity to ask questions and see for yourself if we can help you.
If you’d like one of our limited free consultation sessions, please click here to schedule your free consultation or CALL us on 850-765-2779 to make a no-obligation enquiry.
Dr. Brandon is the owner and a Physio at Body Mechanix Physiotherapy and Fitness. Four of his favorite people call him daddy while he's been married to his other favorite person for 20 years. He enjoys teaching martial arts and is a Mestrando in Capoeira while in the mornings, he can be found working out with the guys in F3 around town. He's the author of 4 pain relief guides for sciatica, low back, shoulder, and knees and the lead contributor to the Active Tallahassee Blog.