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This information is presented with permission from the PainCare Collective and St. Vincent's Hospital Melbourne. Authors: Dr. Anne Daly, Stephanie Carroll and Dr. Philippa Frances. Translations by St. Vincent's Hospital Translation Services.

1. Pain can affect your whole body

Your mood, your body and feelings affect the way you feel pain. The best way to treat pain combines medical, physical and psychological treatments.

2. Ongoing pain does not mean there is new damage

Persistent pain often means that your body’s alarm system has become overactive. It usually does not mean that damage is occurring in your joints. It is safe to move, even though it may not feel completely comfortable.

3. Your emotions and thoughts can change the way you feel pain

It can be stressful to feel pain. Your emotions, thoughts and pain all have an effect on each other. Low mood, depression, and negative thinking can make it harder for you to control the pain. You have probably noticed that being in pain may make these things worse.

There are some helpful ways to deal with these emotions which your physiotherapist or doctor can talk to you about.

4. Sleep is important

Pain can make it hard to sleep. If you are having trouble sleeping, this can make your pain worse, making it harder to cope with your pain. This can then cause problems with your mood and anxiety. It can make a big difference to your pain if you can learn about ways to improve your sleep. It will help you to control the pain.

5. Learning to relax

Relaxation is a natural self-help strategy to reduce tension in our bodies and break the pain-tension cycle.

Relaxation is a skill you need to learn and practice. There are many different ways you can learn to relax. If you practice each one of them a number of times you will find there are some that work better for you than others.

Practicing relaxation will help you become calmer and reduce your tension and pain.

6. Pain can change the way you do things

Try to recognise your behaviour when you have pain – do you continue to do your work no matter how you feel or do you stop what you are doing and rest?

You may have been advised to rest or you may be scared that an increase in pain means more damage. It can be unhelpful for you to rest for a long time if you feel persistent pain. Over time, resting causes joints to become stiffer and muscles weaker. If you stop an activity it can lead to feeling more scared of being active, and this can make you feel worse.

Sometimes, you may be trying your best, and do too much activity just to get things done. You might wait until you are having a good day with less pain and then you undertake lots of jobs you may not have been able to get done. At the end of the day, your pain is very bad and you have to rest, often for several days until the pain settles. You may find yourself repeating this cycle and again feeling more and more helpless and hopeless every time.

The good news is that there is a middle path which can help you to get things done without increasing your pain.

7. How do I begin to increase my activity?

Try to do everyday activities and exercise for a short time and regularly. It’s a way of planning activity to make sure you don’t do too much or too little.

Doing physical activity in small amounts but often helps you improve your physical condition, increase your strength and feel less pain.

If you do social activities such as going to the cinema or shopping with friends for a short time, it helps you feel normal again. It improves your mood, and gives you more and more chances to enjoy life again.

Here is an example of how to increase your activity:

Make sure you follow this routine on good and bad days – don’t be tempted to do more or to do none. This may seem like not enough at the start but you will gradually do more as time goes on.

This process can be applied to any activity from walking the dog to visiting friends.

Your physiotherapist can help you with this.

8. Set some goals for yourself

If there was one thing that you could get back to doing that would really make a big difference to your life what would that be? Discuss this with your physiotherapist.

Goals will keep you motivated throughout your rehabilitation. You can cut a long term goal into smaller goals.

9. Exercise is a form of medicine

When you become less active, your muscles lose strength and tire more easily. This can affect your whole body. So when you start being more active you may feel tired and sore. This is to be expected and you will feel better as your muscles get stronger and as your body gets used to more activity.

Try to have a daily routine. This may include exercises for strengthening, a walk, and relaxation.

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