Module 07 - Taking charge - Kōkiri

Because our pain system is protective, it likes to decide what activities you can and can’t do. This week we are going to look at how you can take charge of day-to-day activities life and activities (physical, social and mental) in the presence of pain. Here is a brief introduction

In this module:

• Pain can dominate your decisions and choices of what you do and commit to
• How to take charge of your day-to-day life and activities despite living with pain
• Tweak how you do things so you can do more over time

[image: A person in red clothes carrying several suitcases. There is a bird sitting on the top of the suitcases. From the left to the right of the picture, the person gradually becomes greener and greener and moves from carrying several suitcases to one backpack, the bird starts to fly, and a fern grows.]

Unfurling

Within the person, a fern unfurls, symbolising the gradual approach of activity pacing when living with pain. Just like how one can't force a fern to unfurl, nor cain pain be forced away.

The colour of the person shows the lessening of pain as they gradually start to increase their activity. This process can be long.

It shows how it isn't a matter of waiting for the pain to subside to do activities, but slowly getting back into normal activities and knowing that it is safe despite the pain.

The third image is of a bird which represents how the pain is not something to be afraid of. In fact, being afraid of it makes it worse and more heightened. It's about coexisting with that pain, and gradually, it will be set free.

Image by illustrator Sarah Wilkins

Watch Barbara explain the interaction between pain and activities. This includes physical, social and mental activities.

When doing things hurts looks at why your body can hurt so much it feels like you must have damaged something and why your body is safer from harm than it feels.

It is understandable that you might avoid doing things that stir up your pain.  Avoiding pain flares by avoiding doing things has the short-term benefit of keeping pain in check on the day.  However, in the longer term it holds a wide range of drawbacks, as Fear Avoidance HE3241 explores. You can also watch this Fear-Avoidance video to find out more about the role of avoidance and how to tackle and reverse this.

It is understandable that you want to push on and complete tasks despite pain and there is good evidence that this can help you remain engaged and active.  However, if a bout of activity takes you out of action for a day or two, your pain is more likely to gradually worsen over time while your level of function deteriorates. If this pattern of doing a lot (booming) and then being out of action for a while (busting) sounds familiar, have a look at Purposeful activity and the boom bust cycle 

Chunking activities during the day and across the week can help you manage you pain as well as get other benefits, like getting more done, feeling less wiped out and feeling more confident in your ability to tackle what is important to you.  Rather than letting pain decide what you do or not do, this is a way of putting your values, interests and skills in the ‘driver seat’.  To illustrate what this might look like, here are some suggestions on how you can schedule activities HE3242 Managing daily activities

Professor Lorimer Mosely, a pain scientist, describes this well when he speaks about how our body learns pain, from time stamp 41:15, with particularly pertinent part to managing activities from 47:28 – 49:07 Pain, the brain and your amazing protectometer - Lorimer Moseley

Practice this STAR exercise in between your activities

Listen to the stories of how people with lived experience of pain manage their activities Taking charge stories

Here is a summary of this module:  Taking Charge handout (attached) HE3239

Tips:

• Regular and repeatable, often and little
• Schedule your day and go steady.
• Do similar amounts of activity on "good" and "bad" pain days. 
• Managing activities with consistency is key.
• Take regular breaks even if it means not finishing something until later.
• Remember your breathing exercises.