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Chronic Pain and the Boom-Bust Cycle

August 22, 2018

A common issue our physical therapists see working at Haven Physical Therapy’s outpatient clinics is when our chronic back, neck and even fibromyalgia pain clients utilize a “Boom Bust” mentality with their daily activities.




What is the Boom-Bust mentality?

When dealing with chronic back or neck pain, many clients attempt to go, go, go (the Boom) and then spend the next 3 days on the couch because they are in so much pain (the Bust). When working with a Haven Physical Therapy back and neck pain specialist we love to see you get out of pain fast, but sometimes that pain relief can lead to an unforeseen ‘Boom’. Our clients may utilize this “Boom” mentality as they start to feel better because it’s the first really good day they have had in months, years, or even decades. You may decide to tackle all of the activities you have been putting off due to pain, but then you experience that unfortunate ‘Bust’ that commonly comes after ‘over doing it’ and it can be very discouraging and disheartening.


This approach to completing tasks is a vicious cycle, and it can be difficult to break without proper guidance from a chronic back and neck pain specialist because it doesn’t leave any room for training your body that it doesn’t have to hurt or be in significant pain to function in everyday life.






How can we break the Boom-Bust cycle?

Haven Physical Therapy’s chronic neck and back pain rehabilitation specialists are experts in using a technique known as ‘Pacing’. Using pacing techniques to help people achieve individualized goals is our ‘secret recipe’ and is what keeps our patients happy and successful (and they LOVE telling their friends and family about us).


How do we use Pacing?

Cleaning your home is an example we like to use because it’s something that most individuals do on a fairly regular basis. We like to encourage clients to break tasks down into smaller more manageable bits that can be performed numerous days throughout the week. Once you break down the task, we help you formulate a ‘game plan’ in writing so you have something to guide you on how to be more active despite chronic back or neck pain.  


For example, say vacuuming is your kryptonite and every time you vacuum you are in excruciating pain for days. If it takes an hour to vacuum the whole house it can be helpful to break the task down into smaller time frames to allow for you to perform the activity without aggravating your back or neck pain and to feel safe while doing so. If a client is able to vacuum for 10 minutes with minimal difficulty, then you vacuum room A for 10 minutes one day, room B for 10 minutes another, and so on and so forth.



Why does pacing work?

Pacing is all about a treatment technique for chronic pain called ‘Graded Activity’. Graded activity is teaching your body to perform a once painful activity in small doses without increasing the pain levels so high you have to call in sick for work the next day. It’s all about exposing you to small doses in a non-threatening way. Over time and through multiple exposures, you no longer associate vacuuming as a dangerous activity, are able to complete the task over several days, and the best part, no longer Bust from pain for days afterward!




In Review

We like to think about getting back to meaningful activities when dealing with chronic pain like this: you can’t train for a 5K but then run a marathon and expect to feel okay when it’s over. Your body wasn’t properly trained for a marathon, and there is a good chance you will be in a great deal of pain the next day. It’s all about gradual exposure, training, and conditioning your body to get back to everyday activities. Starting small and learning how to pace yourself throughout the day will allow you manage your life in a safe, more productive and fulfilling way!


If you are struggling with this Boom Bust mentality and would like to talk with one of Haven Physical Therapy’s chronic neck and back pain specialists, you are in luck! We offer Discovery Visits (link) which are no-obligation sessions where you can discover whether or not physical therapy can help you get back to doing what you love.



If you are struggling with this Boom Bust mentality and would like to talk with one of Haven Physical Therapy’s chronic neck and back pain specialists, you are in luck! We offer Discovery Sessions which are no-obligation consultations where you can discover whether or not physical therapy can help you get back to doing what you love.


      <<Claim your no-obligation discovery session by clicking below>>

Claim your Discovery Session 


P.S.: If you don’t know if a Discovery Session is right for you, we have phone and email options!




- Written by Dr. Jennifer Wynn, DPT.


Jen is a new outpatient therapist for Haven Physical Therapist. She recently relocated to Springfield from Columbia where she practiced for the past 4 years. Jen has a Doctorate of Physical Therapy from Missouri State University and is a Certified Spinal Manual Therapist through the International Spine and Pain Institute. Jen really enjoys working with patients with chronic neck and back conditions who haven't had success with surgery or medication. She believes laughter is the best medicine and that developing trust and strong relationships with patients make all the difference with helping people with pain and returning to function. 


In her free time Jen enjoys going to concerts, spending time at the lake, and fishing (if you count dropping a worm off the edge of a dock fishing!). Three years ago she started running and has participated in numerous 5K, 10K, and marathon relay races since then. She and her husband have five fur babies, two dogs and three cats, half of which are named after Harry Potter characters. :)



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