Practical Guide for People with Pain

Funded by the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the European Education and Culture Executive Agency (EACEA). Neither the European Union nor EACEA can be held responsible for them. ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708 Practical Guide for People with Pain Practical Guide for People with Pain Funded by the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the European Education and Culture Executive Agency (EACEA). Neither the European Union nor EACEA can be held responsible for them. ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708 3 Authors Víctor Doménech-García1, Sofía Albero-Posac1, Julia Blasco-Abadía1, Kieran O’Sullivan2, Lara Coyne2, Mary O’Keeffe3,4, Nathan Skidmore3,5, Zsófia Nagy3,6, Thorvaldur Skuli Palsson7,8, Steffan Wittrup McPhee Christensen9,10, Morten Hoegh9, Domenico Compagnone11, Pedro Berjano11, Lisa Zauber12, Pablo Bellosta-López1. 1 Universidad San Jorge. Campus Universitario, Autov. A23 km 299, 50830. Villanueva de Gállego, Zaragoza, Spain. 2 School of Allied Health, University of Limerick, Ireland. 3 European Pain Federation EFIC, Brussels, Belgium. 4 School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland. 5 Department of Sport, Exercise and Rehabilitation, Northumbria University, UK. 6 Rétköz Health Center, Budapest, Hungary. 7 Department of Clinical Medicine, Aalborg University, Aalborg Denmark. 8 Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Denmark. 9 Department of Health Science and Technology, Aalborg University, Aalborg, Denmark. 10 Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark. 11 IRCCS Ospedale Galeazzi-Sant’Ambrogio, Milan, Italy. 12 Research & Development Department, SYNYO GmbH, Vienna, Austria. Practical Guide for People with Pain Practical Guide for People with Pain Funded by the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the European Education and Culture Executive Agency (EACEA). Neither the European Union nor EACEA can be held responsible for them. ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708 4Funded by the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the European Education and Culture Executive Agency (EACEA). Neither the European Union nor EACEA can be held responsible for them. ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708 5 Disclaimer This document has been developed within the framework of a European project for educational and informational purposes only. The content does not constitute medical advice, diagnosis, or treatment and should not be relied upon as such. Neither the authors nor the project partners assume any responsibility for decisions made based on this material. For any health-related concerns, always seek advice from a qualified healthcare professional. Transparency statement: Generative AI tools were used to assist with drafting, editing, and adapting original raw material created by the DIGI4MSK consortium. All AI-generated outputs were reviewed, verified, and refined by the authors. © November 2025. Digi4MSK. Licensed under CC BY 4.0. https://creativecommons.org/licenses/by/4.0/ doi: https://doi.org/10.54391/123456789/1871 Index Introduction - How to use this book? What does self-management mean? 1. Chronic pain: Does it mean you cannot improve? 1.1. What is chronic pain? 1.2. Why does chronic pain persist? 1.3. What can be done? 2. Is pain always a sign of an injury that has not healed? 2.1. Does pain always mean that there is tissue damage? 2.2. Why can pain continue after healing? 2.3. How to understand persistent pain? 2.4. When to seek help to manage the pain? 3. Is “poor posture” the common cause of back pain? 3.1. Is poor posture really the problem? 3.2. What are the factors besides posture? 4. How does sleep affect pain? 4.1. What is the role of sleep in pain? 4.2. What can you do to improve your sleep? 5. Should you stop all activity when in pain? 5.1. Why is it not helpful to stop all movement? 5.2. When is rest appropriate? 5.3. How to keep moving safely? 6. What is important to know about ibuprofen? 6.1. How does ibuprofen work? 6.2. What are the possible side effects of ibuprofen? 6.3. How to use ibuprofen safely? 9 11 13 14 14 15 17 18 18 18 19 21 22 22 25 26 26 29 30 30 31 33 34 34 34 Practical Guide for People with Pain Practical Guide for People with Pain Funded by the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the European Education and Culture Executive Agency (EACEA). Neither the European Union nor EACEA can be held responsible for them. ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708 6Funded by the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the European Education and Culture Executive Agency (EACEA). Neither the European Union nor EACEA can be held responsible for them. ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708 7 6.4. When to seek medical advice? 7. Should you rely on social media for pain management advice? 7.1. What is the problem with social media health advice? 7.2. How to identify reliable pain management information online? 7.3. Where to find trustworthy pain management advice? 8. New pain as you get older? Here is when to see your healthcare professional (and when not to)! 8.1. Does every new ache really mean you need a visit to a healthcare professional? 8.2. When should you see a healthcare professional? 9. Can your culture affect how you feel or manage pain? 9.1. Why do your beliefs and traditions matter in managing pain? 9.2. How to talk about your pain with your healthcare professional and share your beliefs? 10. Is it safe to keep moving when you are in pain? 10.1. Why does moving help (even when you have pain)? 10.2. How to start and keep moving safely? 11. Can online consultations be as effective as in-person visits for treating pain? 11.1. How can online consultations help with pain? 11.2. What are the benefits of telehealth for pain treatment? 11.3. What are the challenges of online consultations? 11.4. When to seek an in-person visit? 12. Can mental health support help with pain management? 12.1. How are mental health and pain connected? 12.2. What are some mental health strategies for pain management? 12.3. When to Seek Mental Health Support? 13. Can online resources help with pain management? 13.1. How can online resources help? 35 37 38 38 39 41 42 43 45 46 47 49 50 51 53 54 54 55 55 57 58 58 59 61 62 13.2. How to choose reliable online resources? 13.3. When to combine online resources with professional care? 14. Are scans always needed when you have pain? 14.1. Why might an MRI or X-ray not be needed right away? 14.2. What might your doctor tell you (and why might they not order a scan)? 15. Is it important to be part of decisions about your pain treatment? 15.1. How can you be an active partner in your pain treatment through shared decisions? 15.2. How can you and your healthcare professional decide together? 16. Why do your actions matter in long-term pain management? 16.1. Why is your active role key for long-term pain management? 16.2. What does “actively doing” look like? 17. Do you have to follow your exercise plan when you are in pain? 17.1. Why does being flexible with your movement help you? 17.2. How to be flexible with your activity plan? 18. Are ergonomic changes at work or at home the key to managing pain? 18.1. Why does your body love movement more than a “perfect” posture? 18.2. What can you do? Simple tips for a pain-friendly workday 19. How should pain flare-ups be managed? 19.1. What to do during a pain flare-up? 20. Be smart about pain advice: What to trust on social media? 20.1. Why does not “popular” always mean best for your health? 20.2. How to spot reliable health advice online? 63 63 65 66 67 69 70 70 73 74 75 77 78 79 81 82 83 85 86 89 90 90 Introduction - How can I use this book? Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 9 Introduction—How can you use this book? Living with pain can be confusing and difficult to deal with. Many people with musculoskeletal pain—such as back, neck, shoulder, or joint pain—receive large amounts of advice and information from the internet, friends, or healthcare providers. Some of it is helpful, some misleading, and much of it can feel hard to understand. Beyond understanding information, people often struggle to know where to go for help: who to see, what questions to ask, and how to make sense of different opinions. This book is made to help you, your family, and others who want to learn about pain. It will help you understand health information better and find your way more easily when using healthcare services. It aims to make you more confident when searching for help, asking questions, thinking about different treatments, and using advice in everyday life. The goal of this guide is not to tell you what to do, but to support you in learning how to think critically about pain and care, so that you can make good choices and take an active role in your recovery. It will help you to: ■understand pain and how to manage it, in ways that make sense for your situation. ■find and access reliable sources of care and support, both online and in your community. ■decide which advice or treatments you can trust and which are relevant to you. ■use what you learn in daily life, through small, practical steps that help you move more, take part in life, and feel better. ■think about and change common beliefs about pain, so that fear or frustration do not hold you back. Each section of this book focuses on one of these abilities and offers short explanations, selfreflection exercises, and examples drawn from everyday experiences. The short stories you will find—called vignettes—show real situations that people with musculoskeletal pain often face: being unsure about exercising and resting, having difficulties communicating with healthcare professionals, challenges at work, being confused about scan results, medication, or personal goals. These stories are not instructions or medical advice but are made to help you think and learn. Each one shows a skill that can be learned: asking helpful questions, understanding your body, finding good care, or coping with setbacks. Introduction - How can I use this book? Introduction - How can I use this book? Practical Guide for People with Pain Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 10 ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 11 You can read this book from beginning to end or open it at the section that feels most helpful to you right now. Use it as a companion and a guide—something to come back to when you feel lost, when new information confuses you, or when you need encouragement to keep moving forward. From the authors This book was created by a group of healthcare professionals and researchers with lots of experience in musculoskeletal pain care and education. We know that living with pain often means trying to make sense of complex information, visiting different professionals, and facing uncertainty about what to do next. Our goal is to make reliable knowledge and practical guidance available to everyone—patients, relatives, and the general public—so that people feel more confident, informed, and supported in managing pain and using healthcare services effectively. What does self-management mean? Self-management in musculoskeletal pain means learning and using practical skills that help you live well with your condition. It is an active process where you take the main role in looking after your health, while your healthcare team supports and guides you. The idea is simple. There are many things you can do in daily life that make a real difference to your pain, your movement, and your overall wellbeing. Self-management helps you understand these options and use them with confidence. Key elements are: 1. Understanding your condition: You learn what affects your pain, what usually helps, and what tends to make symptoms worse. You also learn how your lifestyle, such as sleep, stress, and daily activity, can influence how you feel. 2. Building confidence to act: You practise trusting your ability to move, exercise, and carry out daily activities. You learn that pain does not always mean harm, and that gradual, steady progress is possible. 3. Using helpful behaviours each day: This includes regular movement, simple home exercises, pacing your tasks, relaxing your body and mind, improving sleep habits, and making healthier choices in daily life. 4. Making informed decisions: You are supported to make choices based on clear and trustworthy information. This helps you decide when to move more, when to rest, and when to ask for help. 5. Managing emotions and stress: Living with pain can be frustrating or worrying. Selfmanagement includes recognising these feelings and using strategies that help you cope, such as breathing exercises, mindfulness, enjoyable activities, or seeking support from others. 6. Working together with your healthcare team: Self-management does not mean doing it all on your own. Your clinician helps you understand your condition, set achievable goals, and choose strategies that fit your daily life and needs. Overall, self-management means gaining the knowledge, skills, and confidence to take charge of your musculoskeletal health. It can help you stay active, feel more in control, and improve your quality of life over time. VIDEO 12. D1.01_ SCAN ME Chronic pain: Does it mean you cannot improve? Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 13 Javier, 47, had spent most of his life lifting heavy materials at construction sites. One morning, after carrying a stack of tiles, a sharp pain shot through his lower back. The doctor said it was probably a muscle strain. Months later, the wound had healed, but the pain still came and went without warning. To understand what was happening, Javier had an MRI. The report mentioned “some disc degeneration and a small disc bulge,” but the specialist explained that many people his age showed the same and had no pain at all. The result only left him more confused. He began to avoid anything that might make things worse. He quit his job, stopped walking the dog, and even turning in bed made him anxious. “If it hurts, something must still be damaged,” he told himself. Some days the pain flared after stress or sleepless nights; other times it eased for no reason. Friends said to rest more, others told him to stretch, and online advice only made it harder to know what to believe. The worst part was not the ache itself but the feeling of being trapped in it—with no clear cause and no clear way out. When his physiotherapist later mentioned that long-lasting pain could act differently from a fresh injury, Javier felt both sceptical and curious. Could pain really change even after years? 1. Chronic pain: Does it mean you cannot improve? Skills you can build by watching the video: ■Understanding what chronic pain means and how it differs from pain after an injury. ■Recognizing common scan findings that do not always explain pain. ■Becoming aware of everyday factors—stress, rest, and activity— that can influence pain over time. YouTube link: https://youtu.be/IfbK36_IDe0 Chronic pain: Does it mean you cannot improve? Chronic pain: Does it mean you cannot improve? Practical Guide for People with Pain Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 14 ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 15 1.1. What is chronic pain? Chronic pain is defined as pain that lasts for more than three months. This label implies that the pain is a little more complex than short-term pain caused by an acute injury. 1.2. Why does chronic pain persist? Science tells us that pain is not just about damage to a body part. Lifestyle choices, activity, sleep quality and other factors such as beliefs, experiences and habits can all make pain feel worse. Changes can occur in the body's protective systems such as the nervous system, which explains why some people feel pain even when scans and blood tests are completely normal. This means they may continue to experience pain without injury. It is like an alarm system that is stuck in the “on” position, even if there is no actual danger. Takeaway messages: Chronic pain means the pain has been there for a while, but with the right management plan, its negative effects can be reduced. If you or someone you know is dealing with chronic pain, know that there are steps you can take. 1.3. What can be done? The good news is that chronic pain can be managed. Just because it has been there for a while does not mean that nothing can be done. Here are some strategies: ■Movement & Exercise. Light physical activity might relieve some of your pain. Gradually increase your activity levels over time. Remember, it may be ok to move even if you have moderate pain! ■Better Sleep & Stress Management. Good sleep can reduce your pain levels, and methods such as meditation or breathing exercises can help reduce stress. ■Professional help. Things associated with a healthy lifestyle (such as sleep, exercise, working, social life, regular diet…) are also likely to help - but most of the time it is not the same thing that helps everyone, so it is important that you find out what helps you. A health professional can be one way to get support in finding out how you can learn to self-manage. VIDEO 12. D1.01_ SCAN ME Is pain always a sign of an injury that has not healed? Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 17 2. Is pain always a sign of an injury that has not healed? Laura, 39, works as a graphic designer. She spends long hours sitting at her desk and often feels a dull ache in her neck and shoulder. It started after a stressful project a few months ago. At first, she thought she had simply “pulled a muscle,” but the ache never fully disappeared. After several visits to different clinics, she received mixed messages: one doctor said her muscles were “inflamed,” another mentioned a “mild disc bulge,” and a third reassured her it was nothing serious. Yet the pain kept returning, especially after long days, poor sleep, or when deadlines piled up. Each time it appeared, Laura worried she had re-injured herself. She tried massage, changed her chair, even stopped doing yoga for fear of making things worse. But nothing explained why the pain seemed to fade for a week, only to come back after an argument or a sleepless night. “If there’s no big injury,” she wondered, “why does it still hurt?” The uncertainty began to shape her days—checking her posture, scanning for twinges, and thinking twice before lifting her bag. The more she worried about harming herself, the more tense her body felt. One afternoon, her physiotherapist gently asked, “What if pain doesn’t always mean new damage?” The question stayed with her long after the session ended. Skills you can build by watching the video: ■Understanding that pain can appear even when tissues are not newly injured. ■Recognizing how different factors—stress, fatigue, or tension— can make the body more sensitive. ■Learning to interpret pain as a message of protection rather than proof of harm. YouTube link: https://youtu.be/EvTdutRb0fE Should you stop all activity when in pain? Should you stop all activity when in pain? Practical Guide for People with Pain Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 30 ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 31 5.1. Why is it not helpful to stop all movement? Taking a break from certain activities can be beneficial if you are in pain, but not moving at all can make things worse: 1. Without movement, muscles and joints can become stiff, making the pain feel worse. 2. Inactivity leads to gradual loss of muscle mass, making it difficult to return to normal activities. 3. The nervous system can become more sensitive if the body is inactive for a long time. 4. Gentle exercise and physical activity in general promote blood flow, which helps circulate oxygen and endorphins, the positive hormones, throughout the body. 5.2. When is rest appropriate? Although movement has a positive effect on pain, there are certain situations where exercise should be limited: 1. If you have severe pain that is made worse by movement. For example, if movement makes the pain worse or very sharp, take a break and try again later. If the pain persists or progresses, you should see a medical doctor. 2. If there are significant signs of injury, such as recent change in the appearance of the limb related to trauma, see a healthcare professional. 3. If the pain is accompanied by other unusual symptoms, such as numbness or fever, see a doctor for an examination. 5.3. How to keep moving safely? Instead of giving up all physical activity, try changing the way you move. Here are some safe ways to stay active: 1. Do low-impact activities. Activities such as walking, cycling or water aerobics are good examples. 2. Modify your movements. Do not stop doing the activities you enjoy but adjust their intensity or range of motion to suit your condition but keep moving. Get an exercise professional such as a physiotherapist to help you do this. 3. Increase your activity gradually. Start with small movements or low intensity and slowly increase as your body gets used to them. Takeaway messages: When you are in pain, stopping all movement is not usually the best choice. Light activity can help reduce pain and stiffness, keep your muscles strong and improve your wellbeing. If you are not sure, speak to your healthcare professional! VIDEO 12. D1.01_ SCAN ME What is important to know about ibuprofen? Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 33 Rosa, 58, works as a school administrator. She has been living with knee pain for years and keeps a small box of ibuprofen in her handbag—just in case. Whenever the pain flares, she takes a pill, sometimes two, and gets through the day. At first, it seemed like a perfect solution. The pain eased, she could walk comfortably, and she did not have to miss work. But lately, Rosa had begun to notice heartburn at night and a heavy feeling in her stomach. “Maybe it’s the stress” she thought, brushing it off. One afternoon, while picking up a new box at the pharmacy, the pharmacist asked, “How often are you taking these?” Rosa hesitated. “Most days” she admitted. The pharmacist explained gently that while ibuprofen helps relieve pain and inflammation, taking it regularly or on an empty stomach can irritate the stomach lining and affect blood pressure or kidneys—especially when combined with other medicines. Rosa listened quietly, realizing she had never mentioned her daily pills to her doctor. She always assumed that, because ibuprofen was sold without a prescription, it was completely safe. That evening, she looked at the half-empty blister pack and wondered how much she really knew about what she was taking. 6. What is important to know about ibuprofen? Skills you can build by watching the video: ■Understanding how ibuprofen works and when it is appropriate to use it. ■Recognizing possible side effects and interactions with other medications. ■Learning how pharmacists and doctors can help you use pain medication safely and effectively. YouTube link: https://youtu.be/OY1Kkz9RNKE What is important to know about ibuprofen? What is important to know about ibuprofen? Practical Guide for People with Pain Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 34 ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 35 6.1. How does ibuprofen work? Ibuprofen is a medicine that helps reduce pain, inflammation and fever. It works by blocking substances in the body called prostaglandins, which cause swelling, redness and pain, when you are injured or sick. It has typically been used in short-term conditions such as sprains, infections or occasional headaches. However, it is not the best choice for managing long-term pain, as prolonged use can have side effects. 6.2. What are the possible side effects of ibuprofen? Some of the most common side effects include: 1. Stomach irritation, which can cause pain, heartburn or, in severe cases, ulcers. 2. Kidney problems, especially in people who already have kidney disease. 3. Increased blood pressure, which puts additional stress on your heart and blood vessels. 4. Cardiovascular risks, as it may increase the likelihood of severe problems in the heart or brain. 6.3. How to use ibuprofen safely? To stay safe using ibuprofen, follow these tips: 1. Keep in mind the dosage. Take the smallest amount that works to relieve your pain. 2. Do not use it for a long time. If you need it for more than a few days, ask your doctor. 3. Take it with food. This helps protect your stomach. 4. Do not mix it with alcohol or other anti-inflammatory drugs. Combining them can increase side effects. 5. Pay attention to how the medication interacts with others. If you take other medication, check with a doctor to avoid problems. 6.4. When to seek medical advice? Although you can buy ibuprofen without a prescription, you should consult your doctor for other options if: 1. You have stomach ulcers, kidney disease or heart problems. 2. You are taking blood thinners or other medicines that may interact with anti-inflammatory drugs. 3. You have had persistent side effects such as stomach pain, black stools, or shortness of breath. Takeaway messages: Ibuprofen can be useful when used correctly, but there are risks to be aware of. Just because it is available without a prescription does not mean it is harmless. Always read the label, stick to the recommended doses and, if you are not sure, ask a doctor! VIDEO 12. D1.01_ SCAN ME Should you rely on social media for pain management advice? Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 37 Daniel, 35, had been working from home since the pandemic began. After months hunched over his laptop, a nagging pain appeared in his right shoulder. Searching for answers, he opened his favourite social media app and typed ‘shoulder pain courses’. Within minutes, he was flooded with videos. One influencer claimed the pain came from a “short upper trapezius muscle.” Another insisted it was an “elevated shoulder caused by emotional stress.” A third warned about “visceral tension from the liver referring pain to the shoulder.” Others talked about “fascia stuck to the ribs” and promoted devices or massages to “release” it. Daniel tried several of the suggested routines—pressing a tennis ball under his shoulder, stretching the “short” muscles, even following a detox recipe “to reduce inflammation.” Some days it seemed to help; others it made things worse. When the pain spread down his arm, he told a colleague, who happened to be a physiotherapist. She listened and asked, “Did any of those people explain how they know what’s happening inside your shoulder?” He paused. None of them had. Their videos were confident but vague—no context. That evening, Daniel watched the same videos again but saw them differently. The bold claims now sounded less like science and more like marketing. He decided it was time to get real advice from someone qualified. 7. Should you rely on social media for pain management advice? Skills you can build by watching the video: ■Identifying unverified or misleading explanations often spread on social media. ■Learning how to check who is behind online health content and what evidence supports it. ■Knowing where to find trustworthy information for understanding and managing shoulder pain. YouTube link: https://youtu.be/ICSfkm1LZrU Should you rely on social media for pain management advice? Should you rely on social media for pain management advice? Practical Guide for People with Pain Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 38 ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 39 7.1. What is the problem with social media health advice? Not all social media advice is backed up by science and there is no standard or ethical board that approves advice on social media. Therefore, you should always consider the risk that advice may be inaccurate, unhelpful or even dangerous. 1. Social media lacks proof and scientific accuracy because anyone can post personal content that can be misleading or false. 2. It is often based on personal experience. What works for one person’s pain may not work for another. 3. Some are used to promote pain treatments without scientific evidence. Many posts are aimed at selling products or exercise-based methods, disguising their commercial purposes. A classic trick is to have you do a test or questionnaire and afterwards tell you what you “need” to become healthy. Most of these tests are unable to detect relevant changes or identify problems in individuals. The tests that are reliable should be used by your healthcare provider who also knows the rest of your story and understands what you want to achieve. 4. Pain management should be personalised, as it is a personal experience. Avoid “one-sizefits-all” solutions! 7.2. How to identify reliable pain management information online? To avoid misinformation, keep these tips in mind when seeking health advice on the internet about pain management: 1. Verify that the information comes from an independent and authorised healthcare professional, a research body or government health agency. 2. See if the information on pain management is accompanied by links to scientific studies and if they align with national or international guidelines published by accredited or governmental agencies. 3. Be critical if something sounds too good to be true! 4. Before following advice, you can consult your trusted healthcare professional specialized in pain. 7.3. Where to find trustworthy pain management advice? In addition to using social media sites that are trusted and verified by your healthcare professional, you can try other trusted sources: 1. Government health websites: organizations like the Centres for Disease Control and Prevention provide reliable information. 2. Medical institutions: the websites from hospitals, universities, and research centres have good insights. For example, World Health Organization has useful information about different types of pain. 3. Licensed healthcare professionals: doctors, physical therapists, and pain specialists can give you personalized and accurate advice. Takeaway messages: Social media can be a place to learn, but it should not be your main source of pain management information. Check information with trusted sources and always talk to a healthcare professional before making decisions related to your health. By thinking carefully and getting advice from people you trust, you can manage your pain safely and effectively! VIDEO 12. D1.01_ SCAN ME New pain as you get older? Here is when to see your healthcare professional (and when not to)! Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 41 8. New pain as you get older? Here is when to see your healthcare professional (and when not to)! Elvira, 69, had always considered herself healthy. She enjoyed long walks, volunteering at the library, and gardening on weekends. Over the past few years, though, she began to notice small, nagging pains that came and went—one week in her hands, the next in her knees or shoulders. Nothing severe, but enough to make her wonder if something was ‘wearing out’. At first, she ignored it. Then, after reading online that “joint pain after sixty means degeneration,” she grew uneasy. The idea that her body was slowly breaking down made her anxious. She started avoiding certain chores, gave up carrying groceries, and even reduced her walks ‘to protect her joints’. Her general practitioner listened to her story and performed a check-up. Everything looked normal for her age—no swelling, no inflammation, no alarming signs. “Your body has lived a lot” the doctor said kindly, “but you’re still strong”. Elvira nodded, though she was not sure what to make of it. If nothing was seriously wrong, why did her body ache more than before? At home that evening, she reflected: the pains were not constant, they did not stop her from sleeping, and they often faded when she stayed active. Maybe her body was simply changing—not breaking. Still, she wanted to know how to tell the difference between natural age-related discomfort and something that truly needed attention. Skills you can build by watching the video: ■Understanding the difference between normal age-related aches and signs that require medical assessment. ■Recognizing how mild, shifting pain patterns often reflect sensitivity or stiffness rather than disease. ■Learning when to monitor symptoms and when it is time to consult a healthcare professional. YouTube link: https://youtu.be/mQG2Ku7uo84 New pain as you get older? Here is when to see your healthcare professional (and when not to)! New pain as you get older? Here is when to see your healthcare professional (and when not to)! Practical Guide for People with Pain Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 42 ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 43 8.1. Does every new ache really mean you need a visit to a healthcare professional? 1. Your body shows “wear and tear”—it is normal! The term “wear and tear” has frequently been used as a stand in for normal age-related changes. Just like our skin gets wrinkles, our bodies also show signs of aging inside. X-rays and MRIs often show wear and tear like arthritis or disc changes as we get older. Many people with these changes feel absolutely no pain! So, a new ache does not automatically mean something is “broken” or needs immediate fixing. It is often just your body adapting. 2. Pain is complex, not just damage: Pain is not just about what is happening in your joints or muscles. It can be influenced by many things: your stress levels, how well you sleep, your mood, and how much you move. These factors often play a bigger role in your pain than a specific “problem” that a test might find. 3. Preventing unnecessary tests and worries: If every ache led to a healthcare professional’s visit and tests, we would all be living in hospitals! For common mild aches that are not severe or accompanied by worrying signs, too many tests can cause unnecessary worry, expose you to unnecessary treatments, and cost money without actually changing the best way to help you feel better. 4. You have the power over your pain: Many common aches and pains, even as you get older, respond incredibly well to things you can do yourself. This includes gentle movement, specific exercises, pacing your activities, and managing stress. These active steps are often the most powerful tools for long-term comfort and for keeping you active. 8.2. When should you see a healthcare professional? While not every ache means a trip to the healthcare professional, there are definitely times when you should seek medical advice. it is important to look out for the following symptoms: 1. Sudden, severe pain that came on for no clear reason. 2. Pain that does not get better with rest or mild activity, or pain that gets worse very quickly. 3. Pain after a significant fall or injury. 4. Pain that wakes you up at night, or increases gradually over days or weeks. 5. Pain accompanied by other worrying symptoms like unexplained weight loss, fever, chills, gradually increasing weakness, numbness, or tingling in your arms or legs, or problems with bladder or bowel control. 6. If your pain limits your daily activities and does not improve with your usual self-care strategies in approximately 3 months. 7. If you have a history of cancer or other serious health conditions that might make certain pains more concerning. 8. If you have a generalised feeling of malaise or feeling notably unwell. Takeaway messages: Do not ignore new pain, but also do not panic. Your body is resilient. For common aches, focusing on movement and self-management is often best. For worrying symptoms or pain that significantly impacts your life, your healthcare professional is your best partner in understanding it and finding the right path forward for your health and well-being. VIDEO 12. D1.01_ SCAN ME Can your culture affect how you feel or manage pain? Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 45 Amina, 54, moved from Morocco to Denmark more than twenty years ago. She works as a home caregiver and spends long hours helping older patients dress and move. Lately, her own lower back has been bothering her. She often wakes with stiffness that eases as the day goes on. At work, she hides it. “I’m fine”, she tells her colleagues when they ask, smiling through the discomfort. In her family, pain has always been something to endure quietly. Growing up, she was taught that complaining means weakness—and that strong people do not burden others with their pain. When the pain worsened after a busy month, her daughter insisted she see a doctor. Amina hesitated. “What if they think I’m exaggerating?”, she said, “Back home, people just keep going”. At the clinic, she struggled to explain exactly how it felt. The doctor spoke kindly but quickly, using words she did not fully understand. She nodded anyway, afraid of seeming impolite. That evening, she talked with a friend from her community who had similar pain but described a very different approach: “In my country, people talk about pain openly—it’s normal to ask for help”. Amina realized that how she spoke about pain was not just personal—it was part of her culture. For the first time, she began to wonder how beliefs, upbringing, and language shape the way people express and manage pain. 9. Can your culture affect how you feel or manage pain? Skills you can build by watching the video: ■Understanding how cultural beliefs and traditions influence the way people interpret and express pain. ■Recognizing that communication styles and expectations about pain differ across cultures. ■Learning how to talk about pain openly with healthcare professionals to get the right support. YouTube link: https://youtu.be/dRZ4ZLV03j4 Can your culture affect how you feel or manage pain? Can your culture affect how you feel or manage pain? Practical Guide for People with Pain Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 46 ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 47 9.1. Why do your beliefs and traditions matter in managing pain? People’s beliefs and traditions can affect how they manage pain in many ways. For example: ■What you believe causes pain: In your culture, you might believe pain comes from aging, certain foods, or even spiritual reasons. These beliefs shape how you interpret and experience your own pain. ■How you express pain: Some traditions teach people to be quiet and strong when in pain, while others encourage showing it openly. Remember that no one can know exactly how you feel, and it takes practice to explain it so that others understand it. But once you learn to communicate how pain affects you, others can start to play a more active role in helping you. ■How you cope with pain: You may have traditional ways of dealing with pain, like using specific home remedies, family practices, or visiting traditional healers. However, it is beneficial for you to seek second opinions provided by healthcare professionals. ■If you seek help and when you seek it: Your traditions might influence whether you believe it is right to see a healthcare professional for pain, or if it is something you should just endure. If you experience that your healthcare professional does not understand you, try to talk about why you believe your behaviour is helpful and ask why their advice can be useful. Because of these differences, sometimes healthcare professionals might not fully understand what you are going through, or the advice they give might not perfectly fit your way of life. Your healthcare professional wants to respect your background and work with you. 9.2. How to talk about your pain with your healthcare professional and share your beliefs? 1. Be open about what you are feeling: Tell your healthcare professional about your pain, and how it affects your daily life. Do not hide or minimize your pain, even if your tradition encourages stoicism. Your healthcare professional needs an honest picture of your discomfort to offer the best care and support. 2. Share your beliefs and traditions about pain: This is very important. Tell your healthcare professional what you believe is causing your pain, or what you have learned from your family or community about it. For example, “In my culture, we believe back pain is normal when you get older,” or “My family uses this herb for headaches.” This helps your healthcare professional to get a better understanding of your perspective. 3. Describe how you usually cope: Explain the methods you have tried or usually use to deal with pain, whether they are traditional practices, home remedies, or just your everyday approach. Sharing this helps your healthcare professional understand your coping style and suggest treatments that align with it. 4. Ask questions and share your preferences: Your healthcare professional wants to work with you to find the best way to manage your pain. If a suggested treatment does not align with your beliefs or traditions, please say so. Ask questions and discuss your concerns openly. Your preferences are crucial for creating a plan that truly fits your life and values. Takeaway messages: It is completely natural for people from different backgrounds to have different beliefs about pain and health. Your healthcare professional’s goal is to help you feel better and they respect your individual story. By openly sharing your beliefs and traditions about pain, you help your healthcare professional provide the most effective and respectful care for you. VIDEO 12. D1.01_ SCAN ME Is it safe to keep moving when you are in pain? Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 49 Thomas, 61, had been a postman for most of his life. He was used to walking long distances every day, but lately his lower back and hips had started aching after long routes. At first, he thought it was just fatigue. Then the pain began showing up even on weekends, when he was resting. He grew worried and cut down his walks, spending more time on the sofa. Strangely, the more he rested, the stiffer he felt. His legs felt heavy in the morning, and he needed extra time to get going. “Maybe I’m doing more harm by moving” he told his wife, “better to let things settle”. One day, while chatting with his neighbour, a retired nurse, he mentioned that even light gardening now made him sore. She listened and asked, “Does it hurt more after you move, or mostly while you’re doing it?” Thomas thought about it. The discomfort usually faded once he got going, and the next day was not any worse. The nurse smiled. “That’s a good sign” she said. “If the pain doesn’t flare up afterwards, your body’s likely coping fine. Some mild pain during activity isn’t dangerous—it just means the tissues are working. But if the pain stays stronger for a day or two after, then maybe the load was too much, and you can adjust next time.” Her words stayed with him. Maybe pain was not always a warning to stop, but a signal to pace himself. That evening, Thomas looked out at his garden and thought about giving it another gentle try. 10. Is it safe to keep moving when you are in pain? Skills you can build by watching the video: ■Understanding that mild pain during activity can be safe and part of recovery. ■Recognizing that a strong or lasting increase in pain after 24–48 hours may indicate the activity was too intense. ■Learning how to monitor pain behaviour and adjust exercise levels to stay active safely. YouTube link: https://youtu.be/fpuX54YQen4 Can online resources help with pain management? Can online resources help with pain management? Practical Guide for People with Pain Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 62 ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 63 13.1. How can online resources help? The internet provides access to tools for managing pain. These include: 1. Educational reports & videos. If you know more about pain science, you can avoid fear and learn how to deal with pain better. 2. Exercise guides. Many websites and apps offer exercises that are backed by science to help you move more easily and feel less stiff. 3. Self-assessment tools. Some online tools let you check your symptoms and track your pain. 4. Support communities. Online forums and peer support groups can be a good source of emotional support and shared experiences. 5. Relaxation & mindfulness. Apps with meditation, breathing exercises, and stress management techniques can help you feel less pain. 13.2. How to choose reliable online resources? Online tools can be a great help for managing pain because they are handy and often teach proven ways to cope. But it is key to pick the right ones. Here is how: 1. Who made it? Is it real science? ■Look for experts: Check if doctors, therapists, or big hospitals created it. ■Is it proven? Does it say it uses methods like “CBT” (Cognitive Behavioural Therapy) or “mindfulness” that research shows work? Skip “magic cures.” 2. Does it help you to do things? Is it easy? ■Make sure it offers tools, not just reading: Look for trackers, guided exercises, or meditations that help you do something. ■Simple to use: Try it out. If it is confusing, you will not use it. 3. Are they honest? Is your info safe? ■Make sure there are no hidden sales: Be careful if they are mostly trying to sell a product. Good resources are open about who pays for them. ■Protect your data: If you sign up, check if your info is safe (look for “https://” and a padlock). 4. Does it offer help, but not a panacea? ■Make sure it works with your healthcare professional: A good online tool supports your current treatment; it does not replace your healthcare professional. Be wary if it claims you will not need any other help anymore. 13.3. When to combine online resources with professional care? Online tools can help you, but they should add to professionals’ advice, not replace it. See a healthcare provider if: 1. Your pain persists or gets worse despite self-management. 2. You notice new and unexplained symptoms. 3. You need personalized treatment beyond general recommendations. VIDEO 12. D1.01_ SCAN ME Are scans always needed when you have pain? Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 65 Can online resources help with pain management? Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 64 Takeaway messages: Online resources can be really helpful for dealing with pain, learning about your condition or supporting you to get moving. But make sure to use trusted sources, and get professional advice if you are not sure if it is right for you. Look for tips on how to handle pain, and try medical websites and digital tools to help you stay healthy. Michael, 50, woke up one morning with sharp pain in his lower back after cleaning the garage. He had not fallen or lifted anything heavy, but the pain felt worrying. “Maybe I slipped a disc”, he thought. After a few days, it still hurt, especially when sitting, and he decided to see his doctor. During the visit, Michael asked directly for an MRI. “I just want to see what’s wrong”, he said. The doctor listened carefully and explained that, in most cases, scans do not change how back pain is treated—especially when there are no warning signs like fever, numbness, or unexplained weakness. “But what if it’s something serious?”, Michael insisted. To reassure him, the doctor described how many people without pain have similar scan results—disc bulges, wear and tear, or age-related changes. “They sound worrying”, she said, “but they’re often normal findings, like wrinkles on the inside”. She suggested waiting a few weeks while he stayed active and monitored his symptoms. At first, Michael felt uneasy. If the pain was real, how could the scan not help? Yet, as the days passed, the pain began to fade. He realized that understanding what scans can and cannot show was part of making sense of his condition—not ignoring it. A month later, he felt much better without ever needing imaging. The relief came not from a picture, but from clearer information. 14. Are scans always needed when you have pain? Skills you can build by watching the video: ■Learning how to decide when a scan is truly useful and when it may not change treatment. ■Understanding that common scan results, like “disc degeneration” or “wear and tear,” can appear even in people without pain. ■Recognizing the importance of discussing options with your healthcare professional before requesting tests. ■Feeling more confident to question and interpret medical information so it makes sense for your situation. YouTube link: https://youtu.be/xZj04gty-VM Are scans always needed when you have pain? Are scans always needed when you have pain? Practical Guide for People with Pain Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 66 ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 67 14.1. Why might an MRI or X-ray not be needed right away? 1. “Normal” findings are common, even without pain: Did you know that many things seen on scans, like disc bulges in your back or degenerative changes, are actually found in lots of people who have no pain at all? For example, studies show that by age 50, about 8 out of 10 people without back pain still have some age-related changes on an MRI. This means those findings are often just normal signs of aging, not the cause of your pain. 2. Scans do not speed up recovery for most common pain: For recent back or neck pain that does not have serious signs or that severely impacts your life, getting a scan early on does not make you recover any faster, but it does increase the risk of slowing your progress back to normal activities such as work. 3. Unnecessary scans can lead to unnecessary steps: Sometimes a scan will identify something like a disc bulge, which is a normal finding, even in people without pain. Unfortunately, such normal findings on a scan can sometimes lead to more tests, specialist visits, injections, or even surgeries that you do not really need. This adds to your frustration, and medical bills, without actually helping your pain. 4. Seeing a scan can make you worry more: Sometimes, seeing a scan with common and harmless findings can actually make you feel more worried or anxious about your body. This extra worry can actually make your pain feel worse. 14.2. What might your doctor tell you (and why might they not order a scan)? Imagine you are talking to your doctor about new back pain. Here is what they might say and why: “I understand why you’re thinking about an MRI, as many people do. It’s natural to want to ‘see’ what’s going on inside. However, for your kind of back pain, which just started and doesn’t have any serious warning signs, we do not recommend a scan. The main reason is that for most common pains like yours, the pain will disappear in a few weeks. Also, scans often show things that are common even in people who have no pain. So, seeing something like that on a scan might just make you worry more, even if it’s not truly causing your current pain. My goal is to help you get better safely and effectively, and for now, that means focusing on staying active and using simple pain relief, rather than jumping straight to a scan that might cause more worry than help. We’ll keep things under review, and if anything changes, we can revisit whether a scan would be helpful.” Takeaway messages: If you have an episode of back or neck pain, you do not always need a scan as a rule of thumb. If you are in doubt, you should consult your doctor, who will know how to reassure you or when to send you to a scan. VIDEO 12. D1.01_ SCAN ME Is it important to be part of decisions about your pain treatment? Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 69 Pauline, 57, had lived with knee pain for several years. At first, her doctor prescribed medication, then physiotherapy, and finally suggested she might consider surgery someday. Each appointment felt quick—she listened, nodded, and followed instructions without asking much. Still, the pain kept returning, and she often wondered if the treatments matched what she actually needed. One morning, her new physiotherapist asked, “What would you like to be able to do if your pain improved?”, Pauline hesitated. No one had ever asked that before. “I’d like to walk with my grandchildren without worrying about stairs”, she said. The therapist smiled. “Then let’s plan around that”. They reviewed options together—specific exercises, pacing strategies, and lifestyle changes—discussing what felt realistic for her schedule and confidence. For the first time, Pauline felt like a partner in her own care, not just a patient receiving orders. Later, during her next doctor’s visit, she explained what was working and what she hoped to keep improving. The doctor listened and adjusted her plan accordingly. Pauline left the office lighter, realizing that treatment worked best when she was part of the decisions. It was not about rejecting professional advice—it was about bringing her voice into the conversation. 15. Is it important to be part of decisions about your pain treatment? Skills you can build by watching the video: ■Learning how to take an active role in making decisions about your pain care. ■Understanding that your goals, preferences, and daily life matter when choosing treatments. ■Knowing how to ask questions and share opinions respectfully with healthcare professionals. ■Feeling more confident in applying information from different sources to choose what works best for you. YouTube link: https://youtu.be/svGOA-QqnwU Is it important to be part of decisions about your pain treatment? Is it important to be part of decisions about your pain treatment? Practical Guide for People with Pain Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 70 ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 71 15.1. How can you be an active partner in your pain treatment through shared decisions? 1. Better consequences for you: When you are involved in choosing your treatment, studies show you will likely feel more informed, less stressed about your choices, and ultimately more satisfied with your care. 2. More likely to stick with it: If you are a part of choosing your treatment plan (like an exercise program or lifestyle changes), you are more likely to understand it and stick with it. This makes it more successful in the long run. 3. Smarter healthcare choices: Being part of the decision can help you choose treatments that truly fit your life and values, potentially avoiding unnecessary or expensive procedures you do not really want or need. 4. Feel more in control: When you have a say in your health decisions, you feel more in charge of your own journey. This can make you feel more confident in managing your pain. 15.2. How can you and your healthcare professional decide together? 1. Talk about what matters to YOU: Your life, your goals, and your worries are very important. Tell your healthcare professional what is most important to you right now or what worries you most about these options (for example avoiding surgery, needing quick pain relief for work or wanting to keep up a hobby). 2. Understand your options clearly: Your healthcare professional should explain all the different ways to treat your pain—like exercises, medications, online programs, or injections. They should tell you the pros and cons for each one, using words you understand, not medical jargon. 3. Make sure you “get it” and ask everything: Do not be shy! Ask your healthcare professional about any information that is unclear or insufficient, but relevant to you. it is fine to take time to think, talk to family, or even get a second opinion. 4. Choose together. No pressure: You should feel like you have enough time to think about your choices. Your healthcare professional will not pressure you. The goal is not one “right” answer, but the best decision for you. Your healthcare professional’s job is to guide and inform you, not to tell you what to do. Takeaway messages: Taking an active role in managing your musculoskeletal pain is powerful. By actively participating in choosing your treatment plan with your healthcare team, you build trust, ensure the care fits your life, and ultimately achieve better results for your health and wellbeing. This collaborative approach respects patient values, builds trust, and ultimately leads to more personalized and successful care journeys. VIDEO 12. D1.01_ SCAN ME Why do your actions matter in long-term pain management? Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 73 Lars, 48, had been struggling with back pain for almost a decade. He had tried everything— painkillers, massages, injections, even several rounds of physiotherapy. Each treatment helped for a short while, but the pain always crept back. “Nothing works”, he often said. His last doctor’s visit felt different. Instead of suggesting another procedure, the physician asked, “What do you do between treatments?”. Lars looked puzzled. “I wait for the pain to calm down”. The doctor nodded. “That’s part of the problem. Long-term improvement often depends on what you do—how you move, rest, manage stress, and keep active.” At first, Lars felt frustrated. It sounded like too much responsibility. But as the weeks went on, he noticed a pattern: the days he walked, stretched, and followed his sleep routine, his pain was milder. On weeks when he skipped activity and spent more time worrying, everything hurt more. During a follow-up video consultation, his physiotherapist helped him set small, realistic goals—ten minutes of walking each morning, short breaks at work, and gentle exercise before bed. “It’s not about fixing it all at once”, she said, “but about building habits that keep your body and mind steady.” Over time, Lars began to see that pain management was not just treatment—it was practice. His actions did not erase pain overnight, but they changed how much space it took in his life. 16. Why do your actions matter in long-term pain management? Skills you can build by watching the video: ■Understanding that your own daily actions—movement, rest, sleep, and habits—play a major role in long-term pain management. ■Learning how to turn professional advice into small, practical routines that fit your life. ■Recognizing that self-management builds control and confidence, even when pain persists. ■Feeling empowered to take consistent steps that make professional treatments more effective. YouTube link: https://youtu.be/83eF2KTvsFs Why do your actions matter in long-term pain management? Why do your actions matter in long-term pain management? Practical Guide for People with Pain Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 74 ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 75 16.1. Why is your active role key for long-term pain management? 1. Passive treatments are often temporary: Pills can reduce pain, and injections can reduce inflammation, but they usually do not fix persistent pain or teach you how to manage your pain beyond the immediate effect. Think of them as tools to help in the short term, not the entire solution. To truly live better with pain, you need to be actively involved. 2. You build lasting strength and skills: Actively engaging in things like exercise, everyday movement, or social activities helps you build physical strength and feel better. But crucially, it also helps you develop vital skills for managing pain. These are fundamental changes that can reduce the negative impact of pain over time and build resilience against future flareups. 3. You learn to cope better, reducing pain’s impact and improving health: Your body is incredibly adaptable. Active self-management strategies—like learning to pace yourself, stress management techniques, and understanding your pain better—can actually re-train your nervous system. 4. You gain control and confidence: When you actively participate in your treatment and learn specific self-management skills, you discover what works for your body and pain. This makes you feel more in control and confident in facing daily challenges, which is a huge part of living better with chronic pain. You become the expert on your own pain journey. 16.2. What does “actively doing” look like? 1. Consistent movement and exercise: Even when it is hard, finding ways to move regularly is essential. It builds physical resilience, improves your mood, and is vital for your overall health, even despite your pain. This could be walks, stretches, specific exercises from a therapist, or activities like yoga or tai chi. And if these activities are done in group, that is even better! 2. Pacing yourself: This is a key skill. It means learning to balance activity and rest to avoid pushing too hard and causing flare-ups. You learn to plan your day, so you can do more over time without exhausting yourself. 3. Stress management and problem solving: Stress can significantly worsen pain. Learning skills like deep breathing, mindfulness, or relaxation techniques can help calm your nervous system and reduce pain intensity. 4. Prioritizing sleep: Poor sleep makes pain worse. Developing good sleep habits is a vital self-management skill that directly impacts your energy levels and pain sensitivity. 5. Healthy lifestyle choices: Eating well, staying hydrated, and avoiding habits like smoking, can reduce inflammation and improve your body’s ability to heal and cope with pain, significantly impacting your long-term health. Takeaway messages: Think of it this way: your healthcare team provides the map and guidance, but you are the one who actively walks the path. The actions and skills you develop and practice each day are what truly build resilience and lead to lasting improvements in your pain and your quality of life. VIDEO 12. D1.01_ SCAN ME Do you have to follow your exercise plan when you are in pain? Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 77 Emma, 45, had been following her exercise plan for shoulder pain for several months. At first, she was proud of her discipline. Every morning before work, she rolled out her mat, did her stretches, and ticked off each exercise exactly as prescribed. She liked the feeling of control—of “doing it right.” But as time went on, things got complicated. Some mornings her shoulder ached more than usual. She hesitated before starting, unsure whether to push through or skip the session. “If I can’t do everything perfectly”, she thought, “then it’s pointless.” That thought grew stronger. On days when the pain flared, she avoided the exercises altogether, promising she would start again properly tomorrow. Then tomorrow became next week. Each missed session left her feeling guilty, as if all her previous effort had been wasted. “Either I follow the plan exactly”, she told herself, “or I might as well not do it at all.” The pain itself had not worsened much, but her stress about doing things “right” had. She spent more time worrying about the rules of the plan than listening to her body. When friends asked how the program was going, she smiled politely and said, “I’ll start again soon.” Every time she saw her unused exercise mat in the corner, she wondered if there was a middle ground—something between perfection and giving up completely. 17. Do you have to follow your exercise plan when you are in pain? Skills you can build by watching the video: ■Understanding that following an exercise plan does not have to be “all or nothing”. ■Learning how to handle days when pain or fatigue make it hard to follow the plan exactly. ■Recognizing that consistency, flexibility, and self-compassion help more than rigid routines. ■Feeling more confident in adapting your activities to your situation without guilt. YouTube link: https://youtu.be/8BSC5aEoAHs Do you have to follow your exercise plan when you are in pain? Do you have to follow your exercise plan when you are in pain? Practical Guide for People with Pain Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 78 ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 79 17.1. Why does being flexible with your movement help you? 1. It keeps you going: Trying to do the exact same exercise on a bad day as on a good day often leads to pain flares. When that happens, it is easy to get discouraged and stop exercising completely. Being flexible means you can adjust, do a little less, or change what you do, so you keep moving and do not give up. 2. You learn what works for your body: Your pain can change day by day. A flexible plan teaches you how to listen to your body and adapt. This helps you figure out what you can safely do on different days, building your confidence and making you feel more in control of your pain. 3. No more “all or nothing” thinking: It is common to think if you cannot do a full workout, it is not worth doing anything. But for pain, some movement is always better than no movement. A flexible plan helps you avoid that “all or nothing” trap. Even a short walk or gentle stretches on a tough day keep you moving forward. 4. It reduces fear and worry: If you are scared that moving will make your pain worse, you will naturally avoid it. Knowing you can change your activity based on how you feel helps reduce that fear. You learn that movement is safe, and you can control how much you do, even with pain. 17.2. How to be flexible with your activity plan? 1. Listen to your body—it is your best guide: Instead of a fixed amount of time or reps, think about how your body feels. If your pain is higher, maybe do less. If you are having a good day, you can do a little more. 2. “Pacing” is key: This means balancing activity with rest. Do not push through pain until you crash. Learn to spread your activities throughout the day or week, taking short breaks before pain gets too bad. 3. Consistency over intensity: Doing something regularly—like a short walk every day—is much more effective for long-term pain management than pushing hard occasionally and then taking weeks off due to a flare-up. 4. Adjust. Do not stop: If your plan says walk for 30 minutes but you are having a bad day, try 10 minutes or just gentle stretching, or even just focus on deep breathing. The goal is to stay as active as your pain allows. 5. Communicate with your healthcare team: Talk to your doctor or physical therapist about how your plan feels. They can help you learn how to adjust your activities safely and effectively, and taking into consideration other aspects such as possible costs. Takeaway messages: Your physical activity plan is a tool to help you live better, not a strict guideline. By learning to be flexible, you empower yourself to keep moving, build resilience, and improve your health and well-being, even with pain in your life. VIDEO 12. D1.01_ SCAN ME Are ergonomic changes at work or at home the key to managing pain? Practical Guide for People with Pain ERASMUS-EDU-2022-PI-ALL-INNO: Project n.101111708. 81 Jonas, 42, worked as an accountant and spent most of his day in front of a computer. Over the past year, he had developed a nagging pain in his neck and lower back that crept in by the afternoon and sometimes followed him home. Convinced that poor posture was to blame, he began searching for the perfect ergonomic setup. He adjusted his chair height, changed his desk, and ordered a special lumbar cushion. For a few days, it seemed to help—but the pain always came back. Each time it did, Jonas grew more frustrated. “Maybe I’m still sitting wrong”, he thought. He began checking his posture constantly, keeping his back perfectly straight and his shoulders tense for hours. Coworkers noticed how stiff he looked. “Relax, Jonas”, one joked, “you look like you’re posing for a photo”. But Jonas could not. He worried that one wrong movement would make the pain worse. At home, he sat the same way on the sofa, always correcting himself, always searching for the right position. When even watching a movie became uncomfortable, he started to feel trapped in his own body. Despite all the adjustments, the pain had not changed much—and now, sitting itself felt like work. Every morning, as he carefully arranged his chair and screen again, Jonas wondered if he was missing something. If posture was not the full answer, then what was? 18. Are ergonomic changes at work or at home the key to managing pain? Skills you can build by watching the video: ■Learning how to apply small, practical changes in daily routines to reduce stiffness and discomfort. ■Understanding that comfort often comes from movement and flexibility, not rigid “perfect” positions. ■Recognizing when to adjust your workspace and when to simply change posture or take a break. ■Feeling more confident in experimenting safely with different ways of sitting, standing, and moving throughout the day. YouTube link: https://youtu.be/q5b8g9SDNow