Boom and bust cycle

When you have chronic pain, it is normal to have good and bad days. It is important to resist doing too much on a good day, which can trap you in a boom and bust cycle, making it harder to manage pain and fatigue. Be patient, pace yourself and build up activity bit-by-bit.

Imagine this…

One morning you wake up early feeling less pain than normal and you can move a bit easier. You feel you are finally having a good day and decide to tackle the long list of jobs you have been putting off.

You work hard all day, with only a few rest breaks because you haven’t had a good day for a while and decide to do as much as possible. You feel you have your pain under control and plan to do even more the next day.

You go to sleep feeling happy that you have got all those jobs done.

What do you think happens the next morning?

You guessed it – you wake up and your pain is worse than normal, your whole body and all your joints are aching. This is a bad pain day. After a few hours of broken sleep, you drag yourself out of bed and barely manage to shower and have some breakfast. You cannot even move enough to start the jobs you had planned for today.

Nothing can distract you from the pain, so you spend the day either resting in bed or slumped on the couch. The pain medication you take does not help. You start to worry that you are having a bad flare-up or that something new is wrong. It all gets too much for you and you end up snapping at your family. You finally fall into bed, but you do not sleep well. The next morning your pain is worse and is bad for another three days.

Does this sound familiar?

This is called the Boom and bust cycle of chronic pain.

Boom and bust cycle of pain

Text version of this graph

This graph shows how when you push through the pain your activity levels go down over time.

When you have chronic pain, it is normal to have good and bad days. You can get trapped in this cycle. When you over-do it on the good days, you will need to rest too much on the bad days. Over time, you will be able to do less and your pain will get worse.

If this cycle continues, you will have fewer good days, and your bad days will last longer and be harder to recover from. It can be hard to plan ahead because you do not know when you will have a good day.

To get out of this cycle, you need to do the same amount of activity everyday – on both good and bad days.

Steadily working on a project or goal can make you feel good and more confident that you will be able to manage your pain. It is hard to know if you are doing too much or not enough – try the tools in the Pacing section to help you get the right balance. The trick is to manage your energy so that you are slowly building it up bit-by-bit. This will help you to manage fatigue and pain.

Be patient – you may feel frustrated because it takes a long time to see progress. In other areas of life, pushing through the pain can be a successful way to get ahead, but unfortunately with chronic pain, the more you push through your pain, the more your pain will push back and get worse. To manage your pain, you need to pace your activities and slowly build bit-by-bit. All the hard work and patience will be worth it.

Does the boom and bust cycle feel familiar to you?

If so, read through the Boom and bust guide and then fill in the Boom and bust worksheet to help you break this cycle and learn to Be Pain Smart.

Use the links below to download the files