A #thread on pacing for persistent #pain

Hope it’s useful.

If so, do share 🙏.

👇

#thepaincoach #pain
1. To pace, you need to know your baseline.

To know your baseline, you need to accept this start point.

Acceptance is tricky. But possible. Sometimes it’s easier and sometimes harder. It is definitely not giving up.

It’s acknowledging where you are now.
2. Pacing helps by organising your activities within windows of tolerance.

You curate good experiences to build upon.

Pushing through etc., is not needed to progress. In fact, pushing usually makes things worse.
3. Set the bar low.

And achieve a win.

And another.

And another.

This changes everything.

Organically, things progress.

But not in a straight line.

There are ups and downs.

Always.
4. How to deal with ups and downs?

You know they will happen.

So, we are consistent with the practices.

Daily habits or pillars that create the conditions for a positive future.

Much is based on self caring and compassion.

Plus creating peace and calm.
5. Pacing creates space.

We all need space.

Between things we do.

Slow down.

Become more focused.

It makes a difference.

Rest and recovery time. We all need it.

Every day.
6. An example.

Walking.

I can walk for 30 mins. Then I suffer.

20?

Suffer a bit.

15.

That’s ok.

This is the baseline.

In the real world, it varies.

Why? Because there are always circumstances.

Be flexible. Be present. Notice your needs.
7. By the way, working in your window of tolerance is not about avoiding pain.

It’s about having positive experiences and nudging sometimes.

Be motivated by hope. Not fear.

Challenging but possible.

Often with guidance and encouragement.

🤙
8. My newsletter is called The Encourager.

Or Encourager for short.

You can sign up here: us6.campaign-archive.com/?u=0d146f92c63…

#thepaincoach #encourager
9. I spend my time helping people understand their pain.

Using the very latest science and philosophy of pain.

There has been a huge advance in thinking over the last few years. In the next tweet I’ll share some of the people who are doing the work.

#thepaincoach
10. Some people doing great work for pain — or better put, people doing amazing work to help suffering human beings to live better lives.

Incredible.

@dibbygibby
@PredictiveLife
@Peter_Stilwell
@sconinxphil
@bannister_lab
@fluffycyborg
@JulianKiverste1

#pain

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More from @painphysio

28 Nov
There’s been an increasing interest in central sensitisation: eg/ a means of diagnosis, courses.

Great on deepening understanding.

But it’s only a part of the picture.

And certainly not an explanation for persistent pain.

(1/2) #pain
(2/2) It would be easy with this to get caught up in the wrong way of thinking about perception.

Input - something happens - output…is not what happens.

Sensory signals the brain receives is only part of the picture. They shape a prediction that’s already been made.
Central sensitisation is going on — it’s a biology.

But it is not a direct cause of pain.

Pain is a perception.

The signals the brain receives can be grounded in CS processes, but that does not automatically result in pain.

We have to generate our experience…. (1/2)
Read 5 tweets
26 Nov
There are different barriers to overcoming #pain.

One is pre-existing beliefs: eg/ possible causes, the types of things that will relieve it, the types of things that won't, how much influence you have, other people fix me etc.

These are all conditioned, so no blame.

1/2
But some may be right and some maybe wrong.

The more we hold onto them without considering other possibilities, the more we may be following the wrong path.

It's tough.

#thepaincoach
Having expectations that exceed the current possibilities is a barrier.

Part of us says 'you should' or 'you must', so we push on.

Even though this is not the best decision right now.

#pain
Read 5 tweets
26 Nov
IMO, there is a place for hands on treatment to help a person suffering persistent pain.

Touch is soothing.

Touch can relieve.

There are different techniques we can show people to use upon themselves or to include loved ones who don’t know what to do.

#thepaincoach #pain Image
1. You can start somewhere that is not sensitive, or at least less sensitive, using mild pressure.

Observe how the person responds - twitches, change in breathing, utterances etc., to get the right level.

Notice the calming, soothing effects.

#touch
2. We can use mild pressure touch on ourselves to soothe and create calm.

This would then be a better state for movement.

In other words, we prime ourselves to move better.

#touch
Read 4 tweets
24 Nov
Pain Coaching is the approach I devised to help people who suffer persistent #pain.

What do I help them do?

Reconnect with what matters.

In so doing, their life improves.

To keep developing, I have daily practices.

Here they are: a #thread.

#thepaincoach

👇
1. Reading practice

Daily reading.

Some factual, some development, some fiction.

I take notes.

I read slowly.

Here are some great tips from @RyanHoliday



#reading
2. Daily exercise.

You choose what this looks like.

I choose running, 5 x a week.

I have a programme designed by @Ultra_Damo

The other days I walk.

I also practice different movements and exercises through the day.

So can you.

#exercise
Read 11 tweets
21 Nov
To understand pain, you need to understand:

A #thread expanding on the prior tweet.

#thepaincoach #pain

👇
1. The person

It’s the person who has a pain experience. Not a body part.

It’s the person we help, guide, treat, encourage.

What’s their story? What is it like being them?

Deep listening clarifies.
2. The person’s lived experience.

This is what it is like to be them.

In their own words, given time and a safe space to talk.

We create that space.
Read 13 tweets
19 Nov
Some important things about persistent pain.

A #thread

#thepaincoach #pain

👇
1. Persistent pain is a challenge because there are no quick fixes.

In fact, we don’t ‘fix’ anything.

There’s nothing to fix. Certainly not the person.

When you understand pain, this makes sense.
2. Pain is whole person.

It’s the person that experiences and lives pain, not the body part.

We help people.

We help them shape something better.
Read 10 tweets

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