Pain & Activity Relationships

Understanding adaptive and maladaptive pain-activity relationships.

In the context of persistent pain, the pain-activity relationship refers to the way one's pain levels interact with and influence their engagement in daily activities. The optimal pain-activity balance involves acknowledging and accepting the presence of pain in our lives while continuing to engage in meaningful activity.

However, many people with pain develop unhealthy or imbalanced relationships between pain and activity as a means of coping, manifesting in two forms: avoidance and persistence. Both can have detrimental effects on physical and emotional well-being. Achieving this optimal balance is crucial for managing persistent pain.


Avoidance occurs when individuals limit their activities or completely abstain from them due to the fear of experiencing pain or worsening their condition. This approach can lead to physical deconditioning, increased pain sensitivity, social isolation, and a decreased quality of life.


In contrast, persistence refers to pushing through pain and continuing with activities despite the discomfort or harm it may cause. This approach can result in increased pain levels, potential injury, and emotional distress from constantly battling against pain.

This is where pacing comes in...

Pacing, a technique that involves gradually and consistently increasing one's exposure to activities while managing pain levels, offers a more balanced and healthy relationship with pain and activity. By implementing pacing strategies, individuals can retrain their brain's perception of pain, improve their physical capabilities, and enhance their overall quality of life.