Pain Management – a Reality Check

Key takeaways from this post:

  • Ongoing pain does not mean your body is fragile, weak or unstable.
  • With ongoing pain, the amount of pain does not correspond with the amount of harm it is causing your body.
  • There is a sweet spot of right amount of effort where you can stay active.


Navigating the world of pain management can be tricky to say the least. It’s time for a reality check regarding the beliefs we hold when it comes to on-going pain and pain management.

I’m not part of our clinical team, I work with marketing. While pain is nothing new to me, I’ve had four knee surgeries, a lot of the science that the Aivo Program is based on is very new to me. It has challenged the way I think about my own pain, and it has taught me a lot. 

What does chronic pain tell about your body?

Are you ready to challenge yourself? Let’s embark on this journey together and take a critical look at commonly held beliefs about ongoing pain and pain management. In this and upcoming blog posts I’ll share things I’ve learned that have been helpful to me. Hopefully these can help you as well. First up we’ll take a closer look at this outdated, yet commonly held belief:

“Chronic pain means the body must be fragile, weak, or unstable.”

Let’s be clear, the above statement is not true. Have you been told any of the above? I know I have. I still think of my knees as unstable, even though I’m physically very active and can do a lot of movements most people can’t. Language is important. Especially when it’s coming from a health care provider, because it has such a huge effect on how we see ourselves.

The fact is, ongoing pain does NOT necessarily mean there is something wrong with your body. Not even when an x-ray or MRI scan shows abnormalities. In fact, research shows that these types of abnormalities are commonly found also in people who don’t experience pain. And in addition, many people who do suffer from pain show no abnormalities on scans.

While normal, acute pain plays by the rules of more hurt, more harm, on-going, or chronic, pain is different. Rarely is there a clear relationship between an injury and the amount of pain. So while the pain is 100% real, it isn’t necessarily causing harm. This has been one of the most helpful realizations for me, because it means I can continue to be physically active. The pain I’m feeling isn’t as big of a threat as I have previously interpreted it to be.

Are you being too active, or not active enough?

It’s all about just finding that sweet spot of Right amount of effort. Turns out, most of us fall into one of two groups: self-protectors or self-pushers. When it comes to exercise I’m a self-pusher. 

Self-protectors dramatically reduce their activity levels and avoid potentially painful situations to protect themselves from pain. A lack of activity can lead to deconditioned muscles and muscle loss. When self-protectors try to return to normal activity a lack of muscle strength causes secondary pain that’s misattributed to on-going pain.

Self-pushers tend to surpass the level of activity that they can handle. Pushing leads to increased pain from overuse and reinforces ongoing pain.

In other words, both approaches can make pain worse, limit recovery, and lead to confusion about how much effort is safe. 

Pain management on your terms

The key is to find how much activity it takes for your pain to flare up, and then do your best to stay under that threshold. Pay attention to how your body feels at different levels of effort. The right amount of effort varies from person to person and may change every day. It may depend on how recently you have taken medication, whether you are getting over a pain flare, or whether your mother-in-law is staying with you for two weeks.  Instead of trying to avoid experiences that can help you get stronger, take it slow and stop when you reach the edge of discomfort. 

Understanding how we think about ourselves, our abilities, and our pain is central to effective pain management. It takes some hard work and commitment, but we can change how we think. That is how we take control of our own pain management.

The Aivo Program is developed for low back pain. You can learn more about our approach here. We are currently recruiting participants for our research study. Click the button below to sign up!