Managing and maintaining changes (back pain management programme)

In the programme so far you have identified goals you want to achieve. These goals will lead to achievements but will require making changes in your lifestyle if they are to be maintained.

Our lifestyle is based on a pattern of behaviour which involves doing the same thing the same way over a long period of time. Changing this therefore, takes time and effort.

Areas that need to change now you have chronic pain are:

• Trying to do as much as before
• Doing jobs all in one go
• Sitting in a bad position
• Bending incorrectly
• Not taking regular exercise
• Sitting in one position for a long period of time
• Overcoming fear of pain and of doing more damage

What helps to maintain changes?

1. Planning
2. Starting with realistic, achievable goals
3. Pacing (see previous leaflet in the programme pack ‘Pacing activities’)
4. Support and help from others
5. Good communication – so others know what you’re doing and why
6. Being motivated – not putting things off or forgetting

Expectations

Expectations link up with our thoughts and beliefs. They can be what you think you should be doing, the results you think you are going to see when making changes, setting goals and wanting to achieve something.

The effect of things in our mind/our beliefs can either be negative – unrealistic, feeling bad, upset – or positive (realistic and achievable).

We know how our thoughts have an effect on how we feel and this affects what we do. It will consequently have an impact on your pain. It is important to focus on what you can do now, not what you used to be able to do.

You need to make positive statements like, ‘I am going to do’ rather than ‘should’, ‘ought to’, ‘got to’, ‘I must’, ‘I need to’. Positive statements can be really helpful, ‘give it a go’, ‘do my best’ rather than ‘I have to do this’.

You need to get a balance so there is no mismatch between your physical and emotional ability and your expectations. Set yourself a challenge but make sure you have a happy middle ground between high and low expectations.

It is also very important that when you focus on what you are able to do now, you recognise any achievements you make. Chronic pain puts a stop to some abilities, something we used to be very good at and very proud of. You need to be able to give yourself encouragement, show an understanding of what is going on and be kind to yourself.