18 May 2011

Balancing Rest and Activity

Having chronic pain is fatiguing.  Physically, we are worn down by the pain whether or not we have been active.  And even that word, activity, is relative: if we have the kind of pain that is exacerbated by activity (usually the case for my migraines) then our idea of activity becomes pretty restricted.  Yet, as my Mom said when she had a bad case of Lyme Disease a few years ago, "You can't just lie around all the time."

Pain with inactivity is as debilitating emotionally and spiritually as it is physically.  I have felt the depression and feelings of "poor me" rise up almost automatically during a period - anywhere from two to seven days - of a migraine that won't go away, especially if I have succumbed to the pain and fatigue. 

But how do we balance the requirements of our pain - to rest, stay quiet and use our pain management skills in peace - with the requirements of physical, emotional and spiritual health?  For me, this has been a journey of discovery, of trial and error.

During 2010, after I left my job at Miriam's House , I thought that lots and lots of rest was what I needed to encourage the migraines to subside, if not go completely away.  I did need a lot of rest - that was 17 years of a very difficult, although much-loved, job - but not for the migraines.  They continued as before.  The change I noticed was not in the migraines themselves but in my ability to manage the pain.  Better-rested (another relative phrase, as sleep interruption often accompanies pain) and able to take the time to experiment, I learned tools and skills in pain management, most of which I have shared in previous posts on this blog. 

I learned that when I am rested, I have more options for physical activity and health, such as a bit of gardening and walking my dog in the park.  And even though these activities often do make the pain worse, I have also learned that, for my emotional and spiritual health, it is often well to make the choice for a time of activity that may exacerbate the physical pain but is worth it in terms of the emotional benefits.

Chronic pain is isolating.  So often it just seems far too taxing to make that phone call, or check - let alone answer! - the emails, or write that post.  In order to hold the pain at bay, we choose not to reach out.  Yet friends, family and those warming, loving connections with others are major components of emotional health.  Although the temptation is to avoid these activities because they leave us even more fatigued and/or in greater pain, the fact is that developing a balanced way to include them in our lives will actually help the pain by improving our emotional health.

I think the trick is, for physical and emotional activity, to experiment and find our own balance.  For me, walking the dog and doing a load of wash may be all I can do before going back to the couch or bed for a 2-hour rest.  For you, getting up and going to the kitchen to sit at the table for breakfast may be the sum of your activities for the morning.  One phone call will leave me light-headed and needing to lie down; you might be able to talk for hours as long as you are resting as you do it.  And, goodness knows, these parameters can change day to day: yesterday's migraine that left me wrung out and weak may today feel like the same migraine, yet I am able to bake scones, put dinner in the crockpot and walk the dog without collapsing.

The key to balance is, for me, being gently understanding of the inexplicable ups and downs of life in chronic pain.  The less judging I do of myself and my abilities, the more I am able to try different tactics, not to mention to forgive myself with a wry grin when something I was sure I could handle turns out to be too much.

I think there are several benefits to this gentle understanding:
* When gentle understanding ("I thought I could handle this ... it's sad that I can't, but I'd better go rest.") replaces harsh judgment ("What an idiot I am ... why did I think I could do this?"), we are bringing into our hearts and spirits a spacious allowing that expands our creativity and our ability to love.
* With greater creativity that comes from allowing and understanding our limitations, we become able to develop pain management and life skills that enhance the quality of our lives.
* This spacious allowing pervades other aspects of our emotional and spiritual lives because the truth is that what makes us impatient and unforgiving of ourselves also makes us impatient and unforgiving of others.  This sort of healing begins in our own hearts toward ourselves.
For me, all of these things point toward greater spiritual health.  And that will be the subject of my next post.

I would love to hear from you.  Please use the Comment link below, or email me at carold.marsh@gmail.com.


  1. As you know, I have chronic musculoskeletal pain. I've had some trouble swallowing a frequent bit of advice offered to people like me: Though pain may make exercise and strenuous activity feel impossible, those things are actually necessary for managing and coping with the pain. I have finally decided to accept this advice and see what comes of it. I've been exercising strenuously (for me) five-six times a week for about six weeks now. In the short term, yes, sometimes I have more aches and pains after a workout. But now I understand that, in spite of that, exercise really does help more than it hurts. I feel stronger. I feel more confident in my body and my abilities. I feel less like an invalid. In a purely physical sense, stronger muscles help with things like balance and posture, which can prevent additional pain. In an emotional sense, feeling good about myself and my body helps me manage my pain better. I don't succumb as often to "Poor me" or "My body is the enemy" or "I'm lazy and weak because I need pain medication." Yeah, I need pain medication, but that medication allows me to work out hard most days, as well as care for my home and my family, which makes me feel strong instead of weak. Without the activity, I'd still need the medication, but I'd be sitting on the couch wishing things were better instead of getting on with my life.

  2. How inspiring, Ellen! And you help me to realize that I could get back to yoga: I accept the Ellen Painter Challenge :)