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Pain is part and parcel of our lives. When we sprain a muscle or twist an ankle or get oven-burnt we cringe in pain. It is unavoidable. It serves the important function of telling our brain that our tissues are damaged, and it goes away. Persistent pain is a fraction of pain that nature cannot heal, that does not resolve over time, and that which could get worse. In persistent low back pain, for instance, the pain serves no purpose in telling the brain for years that there is a problem in the spine. Especially when the MRI scan says there is not much damage! Such pain, which assumes a life of its own, interferes with our daily routine, forces us to quit activities that we enjoy, and generally makes life miserable. The doctors could help with pills, injections, nerve blocks and other rehabilitation methods. The most important tool in managing persistent pain, however, is in our hands. So, what are they?

1. We all have good and bad days. We tend to overdo things when there is less pain and do nothing at all when the pain is severe – the boom/bust cycle. It is crucial to pace our everyday activities by planning adequate breaks, and prioritize the schedule by making a list with a bit of flexibility.
2. Setting SMART (Specific, Measurable, Achievable, Realistic and Time-bound) goals and creating action plans to achieve it are vital. The action plan could be a simple hourly, daily or weekly one. The key is how well we stick to it.
3. The goals might take a while to get to, so being kind and patient with ourselves is essential. Relaxation would help us unwind our minds and help being our good self. Reading a book, listening to music, picking up a hobby, catching up with friends, meditation, gardening… the list of ways we could relax is endless. Let us pick what works for us.
4. Stretching and aerobic exercises such as a brisk walk or a swim not just reduces our discomfort but also prepares our body for more strenuous activities by strengthening our muscles. Exercise, in addition, reduces anxiety, depression and fatigue, and improves stamina, flexibility and sleep. It is necessary to remember that we should start slowly and build up gradually. The notion that exercise could harm the tissues is far from truth. It could hurt, but it does not harm.
5. The road to recovery has enough bumps to throw us off-balance. Pain flare-ups could make us panic and might lessen our motivation to reach our goals. The set backs usually happen when we do not pace ourselves well, overdo things, or forget that we have a pain problem. It is indispensible to have a set back plan and start afresh. It is not as hard as we think. Let us keep going and have fun along the way.