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Q. I’ll have good weekends when I can do a lot and the pain seems better. But, then afterwards, my pain is worse because I was so active. I thought that to make the pain better I needed to be active, but when I’m active I feel worse! What should I do?
A. Yes, this is tricky! For many people with chronic pain increasing daily activity is part of the treatment for recovery. But, finding the balance between helpful levels of increased activity and not overdoing it can be tough! As a general rule, it’s best to increase activity with a slow and steady pace. In the Comfort Ability program we talk about “scaffolding” a return to function. This approach describes how to figure out a baseline (or what you can comfortably accomplish) and then increase by 10-20% every week or so. For example, if you can comfortably walk for 10 minutes a day, a scaffolding plan would suggest that you walk 11 or 12 minutes per day to get started. After a few days, when that feels pretty comfortable, you can increase from there. Small but consistent increases in activity like this build a solid recovery foundation and reduce the setbacks that can come from trying to do too much too soon. Many people find that working with a physical therapist (PT) can be very helpful for these types of approaches. PT’s can help you with an activity pacing program where they can carefully measure increases in function and help to set you on the path for a more consistent recovery. Keep in mind that everyone is different so knowing your personal activity limits --and being mindful not to overdo it while your body is in the process of gaining strength and stamina --is a key part of this process!