Living with chronic pain is exhausting and being a wise 'energy expender' can set you up to get the things you need to do... done while not neglecting the enjoyable pastimes that make life fun.
Energy management refers to planning what to use your personal energy to achieve. While it can often feel like you don't have enough energy to apply to all the things you want to do. Remember that the energy store you have is not fixed and this amount can be increased the fitter we become. However, when you have chronic pain, this needs to be pursued carefully and you may wish to enlist the help of a physio so as not to have a boom-bust cycle of activity. Being able to maintain and increase physical activity without the accompanying exhaustion or pain flare-up will help build a fitter and healthier you.
Deciding what is a priority and what can wait assists you to choose the most important elements in your life. However, chronic pain may affect your ability to plan, particularly if the pain is not currently well managed. Chronic pain can affect the brain's thinking processes. If this is the case, begin with an activity to pursue rather than a goal. Choose something that you have to do and something that you'll like doing. When considering the possibilities, make sure that these are things that you want to do, not what you think others want or need you to do - make them things that are important to you.
Having set times for activities such as a schedule can help you achieve in life even if you live with pain. Routines are about knowing what you are doing and when you're doing it. The schedule can be simply divided into morning and afternoon so there is a degree of flexibility there and you have a good balance between work and pleasure activities. If you're able to get done a 'need to do' activity such as a household chore each morning then you've the rest of the day to look forward to. The routine of completing less pleasurable tasks first and then follow with a pleasurable task means that you're rewarding yourself for your previous effort and success. If you live with chronic pain you may find that you tire easily because the constant pain is exhausting. If this is the case take each activity slowly and keep a record of how much time activities are taking.
Implementing pacing provides you with an effective means of maintaining and increasing physical activity. Pacing involves time limiting activities so that you are staying within the bounds of your pain levels and increasing the amount of physical activity gradually. For a step by step guide to pacing, click here.
Often individuals with chronic pain will have 'better and bad days'. It is important not to save up physical activity for the good days and then go hard at it. If this happens you will surely feel those bad days more and then need a lot of time to rest and recover ie days or weeks. This is called the "Boom-Bust Cycle". To achieve a more even balance it is better to do less on the good days and more on the bad days. This will involve being as active as you can manage, without significantly increasing the pain. An increase in muscle pain is to be expected though, when you are using muscles and joints in new ways. At times, doing more than you can manage (significantly increasing pain levels) might be inevitable eg demands of children. However, if the boom-bust cycle becomes habitual, it can result in a number of side effects:
- Mood swings
- Appetite and weight changes
- Sleep disturbance, insomnia
- Making more mistakes eg forgetting to do things or dropping things
Watch out for these Boom-bust signs
- Being highly motivated to achieve a goal, to the point where you push yourself and significantly increase pain levels
- Bending to pressures from those around you to the point where you significantly increase pain levels
- Having a high number of commitments/responsibilities to meet which significantly increase pain levels
- Feeling anxious about what may happen if things don't get done to the point where you significantly increase pain levels
Performing one major task in small steps a day can lead to a feeling of achievement and build your coping strategies but it will take time and patience. Try and not compare yourself to what you used to be able to achieve before the onset of chronic pain – this is probably not realistic now. Pacing and balancing tasks become skills that can assist with managing chronic pain.
Importantly, the physical actions in themselves can greatly improve motivation so the more you build in interesting and varied activities, the more you are likely to want to do these again.
Being able to maintain and increase the amount of physical activity you can manage - builds a fitter, healthier and more successful you.