Chronic pain
Rebuilding trust in your body when pain is persistent
Nicola Tik
Living with pain can change how you move and how you feel in your body. Sometimes pain continues even when an injury is healing or has healed. Sometimes there is an ongoing condition to manage. Either way, it can make everyday things feel harder than they used to.
The aim of this guide is to help you rebuild confidence step by step, so movement feels more manageable again.
When pain has been around for a while, it is normal to move differently. You might brace, avoid certain positions, or plan your day around what you can tolerate. That is not a personal failing. It is your nervous system doing its best to protect you.
Over time, though, these protective patterns can reduce confidence and make the body feel more sensitive. The reassuring part is that the nervous system can learn safety again, especially with small, paced steps and the right support.
Pick something real and specific that is currently difficult because of pain or flare ups. This could be something you have stopped doing, or something you do but it costs you afterwards.
Examples include carrying a bag, sitting through a meeting, walking to the station, getting back to a class you enjoy, or sleeping in a comfortable position.
Set it as a confidence goal.
Phrase it as “I want this to feel more manageable” or “I want to feel safer doing this for 10 minutes”, rather than chasing a pain score.
Create your safe start.
You are not testing yourself. You are practising the movement in a way that feels manageable, then building gradually. Make the movement smaller by reducing the load, speed, range, or time. Add support if it helps, like using a wall or chair. If symptoms are worse when you are tired or stressed, practise at a calmer time of day.
Aim for “challenging but doable”. A mild stretch or mild discomfort can be ok. Sharp, catching, or escalating pain is your cue to make it smaller or pause and try again later.
A “ladder” is just a way to build confidence in small steps. You start with the easiest version of an activity, then progress one step at a time. This helps you avoid the boom and bust cycle of doing too much on a good day, then flaring up.
How to set your ladder up.
Pick one activity you want to get back to, like walking, lifting, reaching, or sitting. Then write three steps that gradually increase the challenge. Keep the jumps small.
How to use it.
Practise Step 1 for a few days. When Step 1 feels more manageable and less “threatening”, move to Step 2. When Step 2 feels safer, move to Step 3. You do not need it to feel perfect. You are looking for “more manageable”.
Example ladder: walking.
When to move up a rung.
Move up when the current step feels more manageable and does not cause a big flare later that day or the next morning. If it does flare, drop back one step for a few days and build again.
When pain has been around for a while, your body can stay on high alert. Calming cues can reduce that threat feeling so you move more naturally.
Pick one cue and use it consistently for a week:
If it helps, add a simple phrase as you move, such as “safe enough for this step”.
Pain can change day to day for lots of reasons. It often helps to track patterns, so you feel more in control and can build confidence steadily.
After each practice, note three things:
If symptoms spike later that day or the next morning, treat it as useful information, not a setback. It may mean the step was a bit too big for now, or that stress and sleep have turned the sensitivity up. Drop back one rung for a few days, then build again.
If you want an easier way to do this, use VIDA Pain Check in. It helps you track pain alongside sleep, stress, and activity, so patterns are easier to spot and you can adjust earlier.
Consider a GP, physiotherapist, or pain service if you feel stuck, fear is stopping you moving, sleep is consistently disrupted, or your world is shrinking because of pain.