PAIN MANAGEMENT PLAN

Ann C. Jorn, Ph.D. Copyright 2008

Whether in leisure or work-related activity, all of us have a need to be productive. If your pain continuously interferes with your pursuits, you may fall into a roller coaster of over-doing and under-doing. As we discussed in our last chapter, over doing and under-doing are unhelpful activities for pain management. In other words, when you feel better, you over do it and then under do it by having to rest for long periods of time to get the pain under control again. Unfortunately, the longer you rest the weaker your muscles become and the fewer activities you can do without pain. As a result, you may find yourself engaging in not-doing anything even when your pain is reduced and your energy is good.

If you are in this over-doing /under-doing /not doing cycle, you may be viewing pain as an obstacle that must be under a high amount of control in order to engage in activities. You may not understand that pain and, therefore, activity is something to manage. By decreasing the obstacles to activity, you will be able to do more and feel better. So the task at hand is to develop a plan for managing physical activity. Creating your plan will take a definite amount of creativity, patience and determination. Here are 3 important ideas for creating your pain management plan:

1. Up-time and Down-time: Up-time is the amount of time you engage in activity without causing a significant increase in your pain.. Down-time is the amount of time you need to rest in order to avoid a pain flare.

2. Awareness: In order to master the process of pain management, it is important for you to be aware of your body’s pain level.and when it is telling you to rest..

3. Pacing: Pacing involves balancing activities and rest. I encourage my clients to set a timer every 30 minutes and mentally note there pain level. This will help you become more aware of when they need to rest. Now it is important to know that I am not talking about long periods of rest. My clients sometimes think that they will be resting too much and get nothing done. Actually just the opposite is true. You may only need to take a five minute break. If you are taking a 30 minute break then you are probably over doing it.

4. Pain Management Interventions: These are all of the ways you know to help decrease pain. They include relaxation techniques, stretching exercises, leisure activities, rest, hot or ice packs, and medication.

Planning Your Physical Activity

The purpose behind planning your physical activity is to maximize your uptime and to keep your pain levels constant. By planning with this tool you will be able to better control your pain and increase your overall activities and quality of life.

1. Identify the more difficult physical activities that you know tend to increase your pain.

2. Identify activities which you perform on a daily/weekly basis.

3. Take a calendar and map out your activities so that you are spreading them out in a way that does not push your pain out of control. You may have to spread out an individual activity. For instance, lets say that doing the laundry is hard for you. Well for 5 mintutes you may gather the laundry and then rest for two. And then bring it to your machines and rest for a bit and so on.

4. Set a target level of pain for the week. Be realistic!!

5. Use pain interventions prior to, during and after the activity to keep pain level at targeted level.

6. Document the time, activities and situation when your target pain level is exceeded.

Below is an example of a pain management plan.

Write below the activities that increase and decrease you pain.

With the actvities above fill out the form below making sure that you spread out the activites that increase your pain out.

PHYSICAL ACTIVITY PLANNING GUIDE Pain Target ________