What if there were three simple habits to adopt on the path to a pain-free life? Pacing, patience, and persistence are often the unspoken frameworks of a successful rehabilitation program for those with pain. I have seen many patients overcome chronic pain, all of whom have embodied these traits. The 3 Ps help create small, sustainable change in your daily life to begin ending the pain. Do you seek to alleviate your pain? What would your life look like with less pain? Are you ready to live a life without pain? To be successful, these are the three attributes that benefit you on the road to recovery.  I’ll explain what each trait entails, some of the common mistakes people make with each, and how you can avoid common pitfalls. Let’s create a pain-free life!

Habit #1- Pacing

Pacing requires doing a bit more every few days or every week while avoiding the mistake of doing too much too soon. I often see patients struggle when they seek a goal without creating a plan on how to get there. Your program of recovery towards a pain-free life must be organized and timely. Doing too much too fast and without a direction leaves you exhausted and lost! Doing too little too slowly just doesn’t get you anywhere! There are three areas in which you must pace yourself:
Cultivate a Pain-Free Mindset
Pain is all in your brain. We feel sensations in our bodies that our brain interprets as soft, sharp, prickly, itchy, squishy, painful, etc. While there are seemingly endless sensations to experience in the world, sometimes our brain begins to label more and more of the things we feel as painful. The process of allodynia, interpreting everyday non-painful sensations as painful, is implicated in many chronic pain conditions. It works alongside its cousin- hyperalgesia, a process that makes already painful stimuli even more painful [1]. Over time, we begin to associate negative emotions with painful sensations and vice versa. Whenever we feel one, we feel the other. This creates a vicious cycle that perpetuates a life filled with chronic pain.
The good news is you can rewire your brain to begin experiencing less pain starting today. While this requires time, it can be achieved through mindfulness. Creating mindfulness is a daily process. You must re-commitment to changing your mindset each morning. When you feel pain, remind yourself that pain is a normal aspect of life. Resolve to live your life despite the presence of pain. Consciously redirect your thoughts when pain occurs. Over time, you will find that these small changes have the power to change the way our brain assigns the label of pain. Sensations that used to be unbearable will gradually return to being pain-free. The positive effects of mindfulness have been observed in many chronic pain conditions including arthritis, migraines, and cancer [2].
Find Wellness Through Movement
Making physical activity a priority is a crucial part of a pain-free lifestyle. Too often people are scared of exercising, afraid that activity is unsafe since they already experience daily pain. But chronic pain doesn’t mean that you have an unhealed injury. Most injuries will heal within 6 months at the most. Pain persists because of the changes that have happened in our brain. Exercise actually helps to calm down the overly excited nerves involved in allodynia and hyperalgesia. Exercise also releases “feel good” chemicals in your brain called beta-endorphins. These are natural opioid chemicals that are safe, free, and found within our own bodies. You don’t need to consume harmful opioid pain medication when you can release your own natural pain soothing medicine through exercise!
When starting your new exercise program, it’s important to pace yourself. Start with small goals and progressively add new challenges. Perhaps you start by simply walking for 10 minutes each day. Over the following weeks, increase your walking time by a couple minutes each week. Add challenges by walking faster or up and down hills. Gradually start introducing new forms of activity- dancing, hiking, weight-lifting, swimming, etc- as your body becomes familiar with movement again. Find an activity that brings you joy and begin to look forward to exercise and movement. Don’t forget that the little changes you make through the day add up too! Try taking the stairs more often and parking your car at the far edge of the parking lot. Stretch at your desk once an hour if you have back pain. When done properly, exercise should leave you feeling a tiny bit sore, but satisfied. Your body can be strong! You can be strong and pain-free.
Re-engage with Life
Don’t let chronic pain keep you from the activities and people that you love. As you increase your body’s endurance with exercise, begin to gradually re-introduce social activities as well. Many patients with chronic pain will find themselves struggling to keep up with the various social obligations of life, be it birthday parties, doctors appointments, work obligations or shopping trips with friends and family. It’s all too common for people with chronic pain to simply withdraw from daily life.
Participating in these events, even if for just a short time, is better than not participating at all. Research shows us that being around people with love can reduce pain and increase well-being [3]. Be honest with loved ones about your capabilities and give them the opportunity to support you in your journey towards healing. Set a reasonable goal for the length of time you’ll be present at a social event and share it with your friends and family. Accountability will help you reach your goals and reap the benefits of participating in the events you enjoy.
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Habit #2- Patience

All things are difficult before they become easy. Setting and achieving goals is exciting, rewarding, and addictive. Be gentle with yourself and allow ample time to adjust to the lifestyle changes described above. I know it can be tempting to push yourself even harder once your pain begins to recede, but the last thing you want to do is overwork yourself into a flare-up. Flare-ups can be frustrating and lead to feelings of sadness and defeat. They open the door for negative thoughts and increase your risk of pain-catastrophizing, which can inhibit your recovery. Don’t set yourself back by causing a flare-up. Pushing yourself into a flare-up is like attempting to run up a flight of stairs, only to miss a step and fall back to the bottom.
Impatience during your journey towards pain relief can also add stress to your life. Stress is linked to an increase in the hormone cortisol– which when elevated can be inflammatory. If beta-endorphins are a “feel good” chemical, chronically elevated cortisol levels can be seen as the “feel-bad” chemical. Elevated levels are linked to decreased sleep, learning and memory issues, weight gain, and a whole host of other health concerns [4]. All of the effects of stress can only amplify chronic pain conditions. Watch for the following signs that you are doing too much, too fast, and creating stress:

1. Increased heart rate and elevated blood pressure
2. Rapid and shallow breathing
3. Difficulty relaxing
4. New aches and pain
5. Becoming easily agitated or moody
6. Tight or tense muscles
7. Diarrhea, constipation, or nausea
8. Frequent colds
9. Fatigue
10. Problems falling or staying asleep

Stick to your timeline of recovery and celebrate the small achievements you make. Patience requires mindfulness and trust in the process. Over time, the steps you are taking to heal your pain will get you where you want to go. Over-doing it can be just as destructive as doing nothing at all. When it comes to alleviating chronic pain, slow and steady wins every time. Pace it, don’t race it.
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Habit #2- Persistence

Treating pain correctly takes time and persistence. We all would love to swallow a magic pill and make our pain disappear. Pharmaceutical companies want you to believe that their drug can do just that. Some surgeons would like you to think that their surgical procedure can do that too. But chronic pain can’t be resolved in an instant, nor can drugs or surgery target the true root of chronic pain- the brain. Your pain took months to become chronic. Perhaps you’ve been dealing with the pain for years. Just as the onset of your pain took time, so will taking away the pain. You are changing pathways and creating new connections in your brain and nervous system. Neuroplasticity takes time and is best achieved with short but frequent training.
Neuroplasticity of your nervous system and the bioplasticity of your body holds the key to ending chronic pain. It must be achieved in short, repetitive doses. The process of brain plasticity is one of physical neuronal re-organization. Your brain will rewire older connections that were not serving you while building new ones and help extinguish the pain and suffering. This remarkably complex process is occurring every day in our brains- it’s what makes learning possible! We have all crammed the night before an exam, only to forget it all the next day. To truly learn the contents of your high school biology textbook, you would have had to study a little bit every day, reviewing concepts over and over again. Learning to live a pain-free life is a lot like studying. You can’t make the changes happen overnight. But if you reinforce pain-reducing behavior and thoughts every day, you will reap the benefits for years to come.
A pain-free life is possible. Begin your journey today. Think about where in your life you can apply the suggestions of Pacing, Patience, and Persistence.