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Couple Walking

How to stay active with chronic pain

Pain often limits our ability and desire to do things. We may find ourselves doing less and less, until we are no longer doing the things we enjoy or must do.


It is important to remember that while some common activities and basic exercises may seem to increase pain, it is not causing any harm or damage in most cases. Check with your health care provider what physical activities you can do. Participating in frequent activity is often one of the best ways to manage chronic pain in the long term.

Keep reading to better understand how to keep our fear of movement under control. We'll also share new tools, like setting reachable goals and pacing ourselves, which can help promote activity and get us back to doing what we love. 

Addressing fear

Fear of making the pain worse is a common reason people avoid activities. However, this may lead to disability, social isolation, and low mood (sadness or anxiety). Engaging in routine activity despite some pain can help overcome this fear, promote confidence in movement, and lead to decreased levels of pain.

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Setting "SMART" goals

While challenging yourself to be more active, understand that pushing through too much pain and doing too much may lead to pain flares. Flares may have negative consequences and cause setbacks.

Strategies such as (1) setting SMART goals and (2) pacing can promote regular activity while minimizing pain, as described below. 


SMART goals are goals that are specific, measurable, attractive, realistic, and time bound.


Specific goals should be well defined. Think of the who, what, when, and where. 


Measurable goals allow you to track your progress.


Attractive goals should excite or motivate you.


Realistic goals should align with your current life circumstances.


Time bound goals have a set deadline to hold you accountable.

Example: setting "SMART" goals

Flip through these slides for an example of SMART goal setting.

Letty recently completed therapy for chronic low back and knee pain. Her doctor recommended that she continue to exercise, and it was something she enjoys doing. She decided to start walking for exercise. She thought it would help with managing her pain, and help improve her walking ability, as she would like to take her grandkids to Six Flags when they come to town at the end of summer. Letty learned about setting SMART goals in therapy and put it into action with her new exercise goal. 

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Activity pacing

Activity pacing is a self-management strategy where you do short periods of activity, followed by rest over the course of a task. This approach allows you to work within your comfort level and to pause an activity before pain worsens.

Setting a time goal doesn’t mean you should try to finish the task by the end of that time period. Instead, it means to limit the work for a set amount of time, even if there’s more to do. For example, your goal could be “spend 20 minutes cleaning part of the kitchen.” It shouldn’t be "finish cleaning the kitchen in 20 minutes." In short – set a time goal, not a task-completion goal.

It’s OKAY to not finish a task in one stretch. It will take practice to change our expectations.

Visit the Chronic Pain Workbook to learn how to set SMART goals and how to use activity pacing in your daily tasks.

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