The American Chronic Pain Association has issued a list of the basic rights of a chronic pain sufferer. Perhaps one of the most important of them is the right to "do less than you are humanly capable of doing."
In a culture that celebrates efficiency, maximum productivity, and pushing limits, doing less is a radical concept. But Penney Cowan, executive director of the association, believes it is crucial.
"People with pain tend to be overachievers who don't listen to what their body is telling them when the pain starts," says Cowan. "They push themselves until the pain is screaming, instead of stopping when the pain is whimpering."
For many, stopping an activity before it's done may result in a complete reappraisal of how they see themselves.
Andrea Kramer, a back-pain and fibromyalgia sufferer from Montgomery Village, Md., describes herself as "a doer, a pusher, a runner." But as the reality of her condition set in, she had to adjust to the fact that she "couldn't do laundry, dishes, lifting, washing a carit depended upon the level of pain," says Kramer.
The lurking tendency to overdo it
One problem is that even if pain temporarily sidelines the superachiever, that person's underlying mindset doesn't disappear. It just lays low until pain takes a brief vacation.
Then on a good day the go-getter wants to do as much as possible. "You push, you don't pace, you overexert," says Cowan.
Dan Clauw, MD, director of the Chronic Pain and Fatigue Research Center at the University of Michigan, sees this ebb-and-flow pattern all the time and says it's not good for pain management.
"I would suggest that people do the same amount of activity every day so they can even out their peaks and valleys," says Dr. Clauw.
Too many bad days in a row can leave a lot undone, making a pain sufferer feel overwhelmed and melancholy. Cowan says chronic pain demands a clear eye for priorities, which is why she suggests that the pain patient make lists. "Set realistic goals for yourself," she says, "and narrow them down to a point where you're not going to set yourself up for failure."
Accepting your limits is critical
Judy, 49, who runs a headache support group in Nashua, N.H., has taken the "right to do less" mantra to heart. But it's not easy if the price is a less tidy home.
"I've lessened expectations on myself over the years," she explains. "If things don't get done, they don't get done. I just can't get down on myself about them, because it's a choice between trying to feel well and saying my house has to look absolutely perfect."
Amanda, 39, a migraine sufferer who attends Judy's support group, has also learned to pace herself. For example, she cleans early and often, little bits at a time. "My parents are coming in a few weeks, and I've already started cleaning because I have no idea how I'm going to feel. So I do things slowly or piecemeal here and there. I've learned to work around it."