Taking Control of Chronic Pain: How to Avoid the Boom-and-Bust Cycle

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When living with a chronic condition, it’s normal to have “good” days, when symptoms are minimal and manageable, and “bad” days, when symptoms intensify and effect daily activities. For people living with persistent pain, this is a very common experience – some days the pain is mild and other days it’s severe.

In our Digital Joint and Spine program, our members often report severe pain days immediately following a mild pain day. When we ask them to describe their activity levels, we usually find a common theme. On mild pain days, members take advantage of their good day and tend to push themselves too hard while taking care of housework, gardening, exercising, etc.

When you feel good in the moment, it’s easy to get distracted and overdo it, or push through minor pain. However, overexerting yourself on a mild pain day typically leads to worse than normal pain the following day. Sometimes the pain is so severe that pain medication doesn’t help – it may even feel like a new injury. On these types of days, members usually report low productivity because they need to rest, and it’s common for one bad pain day to turn into a few bad days. Then, once the pain decreases, the good day, bad day cycle repeats and eventually becomes a pattern, also known as the “boom-and-bust cycle.”

Unfortunately, the boom-and-bust cycle can lead to fewer good pain days and more bad pain days. At first, it may seem sensible to make the most of mild pain days, but overtime, it can turn into a negative cycle that exacerbates the problem.

How to Manage Pain with Pacing

To prevent getting caught in the boom-and-bust cycle, we teach our Digital Joint and Spine members how to do activities on good and bad days using a tool called pacing. Pacing is a powerful technique that helps people successfully manage their pain and get more done by avoiding the boom-bust trap.

For example, one member told to her Health Coach that she would be “laid up for days” after doing housework. After further conversation, the Health Coach learned that the member lives in a three-story house and that all the pushing, pulling, and twisting she does when vacuuming aggravates her back. The member explained that vacuuming wasn’t a problem right away, but when she was halfway through vacuuming the second floor, she started to have severe back pain.

This member’s Health Coach helped her realize that minimal vacuuming didn’t make her back pain flare up but vacuuming for long periods of time caused a problem. Together, they created a plan to spread out, or “pace,” vacuuming throughout the day. The member found that if she vacuumed one floor, then stopped vacuuming to do something else for about an hour, she could finish vacuuming the whole house without feeling terrible afterwards. While it took her longer to complete the housework, she was thrilled to discover that this simple strategy could save her a lot of pain and suffering.              

If this sounds familiar, you may be experiencing your own boom-and-bust cycle. To help break this habit and learn how to apply the pacing technique, check out this video.

If you aren’t sure where to start, or you would like help using the pacing technique in your daily routine, contact your Health Coach today by sending them a message in the Digital Joint and Spine app.