The Self-Management Toolkit

A selection of tools to help you along the way

1 Accept that you have long-term health condition....and then begin to move on

Acceptance is the first and the most important tool in your pain self- management toolkit.

Acceptance is not about giving up. It is recognising that you need to take more control and find how you can self-manage your pain better.

Acceptance is also a bit like opening a door - a door that will open to allow you into lots of self-managing opportunities. The key that you need to open this door is not as large as you think.

All you have to do is to be willing to use it and try and do things differently. 

Watch a video overview by Pete Moore.

Older Lady

My goal was to get back to working in my garden, so action planned how I was going to do it. I also used pacing, because I was a terrible over-doer.

2 Get involved - building a support team

Being successful in self-management means getting both help and support from others.

Ask your healthcare professional, friends, family and work colleagues about working more together - becoming a team.

Develop a self-management action plan.

Find out if there are any support groups in your community or online you could join which could provide you with more self-help management skills. 

Watch a video overview by Pete Moore.

3 Pacing daily activities

Pacing our daily activities is one of the key tools and it helps us avoid the Boom and Bust Cycle, which many of us fall into.

Do you do too much on your good days, and less on your bad ones? Look at the illustration below and see if you recognise yourself.

Pacing in short is taking a break before you need it throughout the day.

Due to fatigue and what is called PEM (Post Exertional Malaise) which is common in long Covid, it is really important that you do take into account the huge importance of pacing.

This malaise can occur straight after or even 24hours to 72 hours post exertion and leads nicely into Tool 4.

Watch a video overview by Pete Moore.

4 Learn to prioritise and plan out your days

Prioritising and planning your days are essential skills. Make a list of things you would like to do but remember to be flexible. It is a great way to set yourself a starting point.

  • Monday a.m. - vacuum the living room and have a couple of breaks so that I pace myself
  • Monday p.m.- prepare food for evening meal - sit down to do this
  • Tuesday a.m. - go swimming - meet a friend for a coffee/tea - practise some relaxation when I get home.
  • Tuesday p.m. - Write an activity plan for the next day.

Checkout the Pain Toolkit 3 P’s video It highlights the importance to:

  • Plan
  • Prioritise
  • Pace

Watch a video overview by Pete Moore.

5 Setting Goals/Action Plans

For many people, they can feel stuck. Don’t worry, it’s common.

You may sometimes want to run before you can walk, so to avoid this happening, set yourself simple realistic goals or action plans. Just as you need goal posts when playing football or a finishing line when racing - you need something to aim for every day. It can increase your confidence to do other activities you may have stopped doing, because of the pain.

Perhaps, you could set yourself a simple hourly, daily or weekly action plan. If you are not sure how to do so and need more help, then ask for support from your healthcare team. 

Watch a video overview by Pete Moore.

6 Being patient with yourself

Take things steadily. It may take you a few weeks or months to see changes or improvements. When you start to feel good, you may want to catch up with activities that you may have let go of.

Don’t be tempted to overdo it otherwise your chances of yet another setback could increase.

A good saying is "take things one day at a time". And also ask for help and support from others. It’s not a sign of weakness but a sign of strength. 

Watch a video overview by Pete Moore.

7 Learn relaxation skills

Relaxation skills are very important for tense muscles and for unwinding the mind. Relaxation could be:

  • Reading a book
  • Listening to some music
  • Gardening
  • Meeting friends for a coffee/tea
  • Going to the cinema or a restaurant
  • Relaxation exercises
  • Meditation (Mindfulness)
  • Dancing
  • Walking

Here are some relaxation tips from Dr Sue Peacock who specialises in pain and sleep problems.

Coping or self-managing? Coping with a health condition can be like playing a game of snakes and ladders - a game of luck. Being an overachiever, you can tend to do more on good days (climb the ladder) and on bad days, do less and return to bed. (This is like sliding down the snake). 

Self-managing is taking positive, planned action which can reduce the ‘luck’ element. 

Watch a video overview by Pete Moore.

8 Keeping active, movement, stretching & exercising

So, keeping active, movement, exercise and stretch needs to be taken really slowly.

One day maybe just doing some gentle arm stretches and it needs to be taken a day at a time. But even some very gentle bed exercises with some breathing control can be really valuable. It is all about finding your baseline (a starting point) and then working from there.

Getting breathlessness while exercising is usual. If you have been medically cleared but you are still struggling, here is some useful information from the NHS about breathlessness, managing breathlessness from The British Lung Foundation and getting moving again. Caution though on increasing levels of activity too quickly as this has been found not to be good for Long Covid, if in doubt discuss with GP or therapist.

Many people with pain fear starting to get active and exercising, in case it causes more problems, like increasing their pain. I used to think like that, however this is not true.

Getting active and regular stretching and exercising can actually decrease pain and discomfort.

Watch a video overview by Pete Moore.

IMPORTANT: Monitor fatigue and post exertion malaise as it is important to avoid aggravating these symptoms.

Regular stretching/exercising can strengthen weak muscles and you will feel better for it. Remember to start slowly. It is not as hard as you think. Cats and dogs stretch, every time they get up. Why? Because they are preparing themselves for moving. Remember unfit and under-used muscles feel more pain than toned ones. Talk with your physiotherapist or fitness coach about developing a tailored stretching and exercise programme that you can work on steadily and safely. This will help build your confidence as well as muscle and joint strength.

Remember that swimming (or just walking up and down in the pool) is a low impact exercise and is good for you if you have joint problems. 

Useful information from the Chartered Society of Physiotherapy (CSP) 

9 Keep a diary and track your progress

Keeping a diary of your progress will help you to see how far you have come and note the successes you have achieved. This will help you to build on success. But it is also handy to note what didn’t work so you can learn from those experiences.

We sometimes learn more from our errors and not from our successes.

Personally, I found keeping a diary showed me how well I was doing in self-managing my pain.

Problem Solving: watch this video, to learn simple Problem-Solving skills. Also taught, on Self-Management Toolkit workshops.

Watch a video overview by Pete Moore.

10 Have a setback plan

Is it realistic to think you will never have a setback? The simple answer is NO !

Developing a setback plan is good pain self-management. Ask your healthcare provider if you need help in making one if you are not sure.

Make a note of what triggered your setback and also what helped. This could be useful information if and when you experience another and help you get back in the driving seat more quickly. 

Watch a video overview by Pete Moore.

11 Teamwork

Teamwork between you and your healthcare team is vital. Imagine the Arsenal football or any team playing without a team plan.

Managing your pain is not a ‘one-way street’ and it is unrealistic to think your healthcare can totally resolve it. You have an important part to play as well. Together both you and your healthcare professional can set an action plan. This action plan could help you both track your progress.

Action planning is taught when you attend a pain or self-management programme.

Watch a video overview by Pete Moore.

12 Keeping it up... and being more resilient

You may be asking yourself; do I have to put these tools into daily practice? What, everyday? The simple answer is YES. Just as the person with diabetes has to take their treatment/medication and maintain their daily diet, your treatment is:

  • Planning/prioritising
  • Pacing
  • Setting weekly or long-term goals/action plans
  • Relaxation
  • Exercising

Generally keeping active and being in charge of your health condition and becoming more resilient.

Keeping it up is difficult for many people but it’s not as hard as you think once you have set yourself a routine. Just like brushing your teeth, self-managing your health will become a habit. 

Watch a video overview by Pete Moore.

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