Handy Tips & Links

Handy tips, useful information and more

Examples of pacing your daily activities

Ironing

As an alternative to doing a large amount in all one go, do smaller amounts frequently. Instead of doing the whole washing load of ironing at once, spread it over a period of days. e.g. have two or three piles. An urgent pile a not so urgent pile, and... I can do that at the end of the week pile.

Shopping

Instead of doing one large weekly shop cut it down to a few trips to the shops per week.

Divide your shopping into more bags, so that you are not lifting and carrying heavy bags.

Remember to ask staff to help carry the shopping and put it in your car; remembering to get someone (family or a neighbour) at home to lift and carry your shopping into the home. Or consider Internet shopping, and then you just have to pack the items away once they have been delivered to your home.

These are just a couple of examples. There may be many other everyday activities that you need to think through before you tackle them. If you stop and think about what you intend to do BEFORE you do it, then there is less of a chance that you will have a setback and in turn increase your pain.

Remember pacing is ‘taking a break before you need it’ and spreading out your daily activities. 

Pace yourself

Break up tasks into smaller portions. Rest in between. Reduce your activities until the setback settles. Be kind to yourself. Say ‘NO’ to any unnecessary demands put upon you until you are feeling healthier. And.... don’t be too proud or scared to ASK for help!

Organising a Setback Plan

It is not realistic to think that you will never have a setback ever again. Remember if you are an overachiever; it is easy to forget to pace yourself and in turn you may experience a setback.

So, the first thing not to do is panic, but many people do. It is best to have a setback plan ready if one occurs.

Setbacks are usually caused by doing too much - overdoing it, pressure from others, or just forgetting you have a pain problem. Try not to get annoyed with yourself, it can cause more stress and pain.

Don't forget to stretch before and after most physical activities to avoid a setback! If you are not sure how to prepare a setback plan, ask your GP or healthcare professional for help. 

Taking your medication

Follow or ask the advice of your Doctor, GP or Pharmacist about medication and when you need to take it. 

If you have to take regular medication, think of ways to remind yourself to take it. Many people just simply forget. Use post it notes, a timer or get someone to remind you. Please remember that taking medication if you have musculoskeletal pain (back, leg, arm, neck etc.) may mask the pain and encourage you to do more. 

For musculoskeletal pain (back, leg, arm, neck etc.) 

Apply heat and/or ice in a way that makes you most comfortable. To relieve initial pain, you could apply ice packs wrapped in damp towels for 5 minutes every hour for the first one or two days.

Always make sure you have a cloth of some type between your skin and the ice, to prevent burning the skin and causing an ice burn. It is not recommended that you lie on an ice pack. (People with rheumatic problems may prefer to use heat rather than ice).

Again, if you are not sure, seek advice from your GP or healthcare professional. 

Take it easy

Briefly cutback on normal activities, lie or sit down for a short while and relax but not for too long. Bed rest weakens muscle strength rapidly, you lose about 1% of total muscle strength a day if you become inactive - remember keeping active and mobile can actually speed your recovery, but caution with the fatigue. Try to start moving gently Remember to pace yourself. Begin gentle stretching and movement as soon as possible to regain normal suppleness. Keeping active may seem alien to you, but in pain self-management terms, learning to live with a persistent pain is a skill to be learned. Don’t be put off, it does work! 

Relaxation 

Using relaxation is another good way of managing a setback. Accept it is just a setback, and as it came, it will leave. Check out the website Living with Pain for free downloadable simple relaxation skills/techniques. 

15 reasons why... getting and active, stretching and exercising (don’t forget swimming) is good for you and could help reduce your pain.

  • Helps to improve and maintain good overall health
  • Increases strong cardiovascular system - heart lungs and blood vessels
  • Helps to improve and maintain good overall health
  • Increases your muscle strength
  • Improves your flexibility
  • Increases your endurance and stamina
  • Helps to improve quality of sleep
  • Helps with your balance and coordination
  • Reduces your fatigue and increases energy
  • Reduces muscular tension, stress and depression
  • Helps to combat depression and anxiety
  • Helps to maintain a positive outlook
  • Helps to prevent constipation
  • Ca be sociable
  • Increases natural pain killers (called endorphins) in the body’s nervous system which help control pain
  • Helps with weight control

Before starting any exercise programme, also see a Physiotherapist to get the right stretching and exercises for you.

Drinking water

Water is essential for a healthy life so drinking plenty of water is important for everyone. It’s even more important if you are taking part in physical exercise, so make sure you keep properly hydrated before, during and after exercising. 

Self-management programmes (SMP’s)

These are run in the community by highly trained tutors who also have persistent health conditions themselves but have learned to become good self-managers.

The Expert Patients Programme is run in some areas. For more information, where they are run, please contact Talking Health.

Similar courses are run in America, Australia, Canada, Ireland and New Zealand. 

Pain Management Programmes 

(PMP’s) are run by a multidisciplinary team of healthcare professionals, supporting people with pain to learn extra skills, to self-manage their pain and are available in most areas of the UK.

(Message from Pete. I went on a PMP in 1996, and it turned my life around. If you have the opportunity to attend a PMP, then do so.”)

For more information about a Pain Management Programme and how they work, please click here This information is provided by the British Pain Society Your healthcare team can help you find a local PMP. Remember PMP’s and SMP’s can provide you with many self-management tools, but you have to do the work.

Health Talk Online has a great website to read, hear and see people’s experiences living with long-term health conditions. The NHS is the online ‘front door’ to the NHS. It is the UK’s biggest health website and gives all the information you need to make choices about your health. (Tip from Pete I use it all the time.) Check out Understanding Pain in less than five minutes video. It shows and explains how pain works and handy tips on how to self-manage it. 

Supporting your recovery after COVID-19

The NHS has an excellent link dedicated to supporting your recovery and it covers…

  • Breathlessness
  • Fatigue
  • Coughing
  • Managing your oxygen
  • Taste and smell
  • Voice and swallowing
  • Musculoskeletal Shoulder and Back Pain
  • Managing Fear and Anxiety
  • Managing your mood and frustration
  • Memory and concentration

Exercise programmes

Here are a few common ones:

Yoga Tai Chi Pilates Please make sure that your teacher is qualified and experienced in teaching people with persistent pain. You should be encouraged to exercise at a pace that feels right for you.

Good websites to visit for getting active/exercise: Get active your way Walk for life NHS Fitness Studio (open 24hrs and free) 

Body Care

Looking after your whole body is very important, so please think about:

Sleep - sleeping only at night and avoiding cat naps during the day unless fatigue is an issue in which case rest as required and monitor impact on night- time sleeping.

Hygiene - washing and grooming your body daily. Looking after your body is very important and so it is vital that you look at what you put into it, that you get enough of the healthier types of food and the right amount of sleep and you also keep yourself clean. 

Sleep problems, things to avoid...

Napping during the day or going to bed early to try to ‘catch up’. BUT if fatigue an issue and still sleeping at night then rests during the day maybe required.

Things to avoid

  • Napping during the day or going to bed early to try to ‘catch up’.
  • Lying in bed awake for hours feeling frustrated.
  • Having caffeine, nicotine, or alcohol within six hours of going to bed.
  • Exercising within four hours of going to bed.
  • Eating a big meal before going to bed.
  • Watching TV or listening to the radio in the bedroom.
  • Worrying about sleep or trying very hard to make yourself fall asleep. These will probably keep you awake.

The do’s

  • Try to get into a regular routine of sleep times, and get up on time even if you are still tired.
  • If you can, give yourself 60-90 minutes to ‘wind down’ before going to bed.
  • If you are lying in bed awake, get up and do something different until you feel tired again.
  • Use distraction to help get your mind to think about pleasant events, recite poems or song lyrics so there is less room for pain thoughts.
  • Do some relaxation and deep breathing from the stomach exercises (ask a healthcare professional to show you how too if not sure how to).
  • Exercise during the day or get up if you cannot sleep and do not go to bed till you feel tired.

Depression and anxiety can also cause sleep problems, so talk to your GP and ask to see a Cognitive Behavioural Therapist (CBT) who has expert skills about sleep problems. Talking therapy can help get better sleep and moods.

Useful video from Dr Sue Peacock for more useful tips, regarding Pain and Sleep. 

Long-term condition and work

Returning to work for people with pain can be tricky. Many employers do not understand the challenges they have. Some people have to give up work because of their ongoing symptoms. I’m still working in spite of my pain and other long-term health conditions.

The main thing to remember is to be honest about the difficulties you may have at work with your boss. Work out an action plan with them including how you can carry out your duties, perhaps differently to others. Taking more regular breaks may mean that you have to add on extra time to your usual working day in comparison to others. 

I would like to return to work but my pain stops me

Many people may have to give up work because of their pain. It is important to look for other types of work that will suit you and your long-term condition. I know it may sound odd but working is actually good for us, so we can interact with others and to provide you and your family with an income. It is well-known that pain can make many people feel isolated and out of touch and the more time you spend off work, the harder it is getting back. Try to avoid waiting for your pain to be completely gone before you start work, it’s unrealistic thinking.

Handy tip

For many people, being self-employed (being your own boss) suits people with pain/long term health condition because it provides them with flexibility as to how they work. They can set their own timetable, when they start and finish work and take breaks when they want or need to.

What work could you do?

That is up to you, and as always, speak to others to discuss your ideas. It could be an exciting prospect to do work you have always wanted to do, but never thought the opportunity would come around. I used to be a driving instructor, but always wanted to write. In my case, pain has given me the opportunity to do just that. 

Feedback from people who have used the Toolkits

I found the ‘pacing’ tool most effective for me. I was one of those people who always did an activity until the pain became too excruciating and only then I would stop. Now that I pace my activities, I feel I can do more without the pain increasing. Keeping a pain diary also helped me to see where I was doing too much.

H.T London

Becoming more resilient really helped me. When I attended one of Pete's online workshops, Pete and the group talked about how they had become more resilient. To be honest I didn't know what it meant so had to look it up. I liked this explanation; knowing how to manage in spite of setbacks, or barriers, or limited resources. Resilience is a measure of how much you want something and how much you are willing, and able, too overcome obstacles to get it. It has to do with your emotional strength. This made perfect sense to me and soon became resilient.

N.N Yorkshire

For me every day was the same. Get up, have breakfast, watch TV, have lunch, watch TV, the family would come home from work, watch more TV. Learning to set simple action plans has helped me to break these boring habits. I now set simple goals so that I regularly stretch and exercise and of course include relaxation. Guess what? I now watch less TV. I feel more in control and have less pain.

B.B Essex

Having a setback for me was priceless. I’m one of those overachiever people Pete talks about. I always seem to be overdoing it so I get spikes with my pain, but having a setback plan soon gets me back on track. My practice nurse helped me make one.

S.C Wales

About Pete Moore, author of the Pain & Self-Management Toolkits

Pete lives in North East Essex, in the UK and is a keen promoter of self-management and other health conditions. When he’s not involved in pain management, he’s out riding his Harley. Pete has written several pain self-management programmes and books. He is often asked to provide educational seminars for healthcare professionals and patient groups in the UK, Europe and around the world.

Memberships etc

Pete says ‘Self-managing pain or a health problem is not as hard as you think and the best way to approach it is by taking small steps.”

As the saying goes ‘we want to run before we can walk’. Be patient with yourself. Easy-does-it. You will get there.

Always ask for help and support from your healthcare professional, family, friends and work colleagues. In time you will become more confident and in control.

Thanks to others who helped in the very early versions of the Pain Toolkit. Also, to all the healthcare professionals and patient groups who support pain self-management.

Take home message from Katie

Katie says "Breaking management down into bite-size pieces makes this a possible for all. A great way to start getting your life back on track. Celebrate every success and check you have that support team cheering you on, Pete and I will certainly be!"

Follow Katie Online on:

Useful website links for more information and support in the UK

Important: All the links below are to non-commercial organisations in the UK. Please remember to discuss with your doctor or healthcare professional before trying a treatment, procedure or just unsure of any health matter.

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