Resources

Staying Active with Persistent Pain

Daniel Smit | Physiotherapist

Practical ways to keep moving, manage flare-ups and build towards what matters to you.

Persistent pain can make everyday movement feel difficult or uncertain. You may worry that activity will worsen symptoms, or find that doing a lot on a better day is followed by a flare. A flexible plan can help you stay connected to daily life and gradually build activity around your goals. You do not have to wait for pain to disappear before taking a manageable next step.

What is persistent pain?

Persistent pain is pain that continues or returns for longer than expected, often for three months or more. It can follow an injury or illness, occur with an ongoing health condition, or persist after tissues have healed. It is real and deserves care. Pain intensity does not always show how much tissue damage is present, although some conditions still need specific treatment or monitoring. A clinician can help consider the whole picture and check whether a new or changing symptom needs investigation.

Why staying active can help

Regular movement supports strength, mobility, cardiovascular health, sleep, mood and confidence. It can also help reduce the loss of capacity that may happen when pain leads to prolonged inactivity. The best starting point is an activity that feels relevant and achievable for you. It might be walking, gentle cycling, water-based activity, household tasks, gardening, mobility exercises or returning to a valued hobby.

Activity is one part of pain care. Your plan may also need to address sleep, stress, medication, work or caring demands, other health conditions and the things you want to get back to. If you have a condition that needs specific activity advice, follow your treating team’s recommendations.

Start with a manageable amount

Choose something that matters. Pick one everyday activity or form of movement you would like to maintain or build.
Find a repeatable starting point. Notice what you can do on an average day, not only on your best day. If activity levels vary, try a smaller amount that you can repeat more consistently.
Break it into shorter parts. A few brief walks or movement breaks may be more manageable than one long session. You can also alternate heavier and lighter tasks.
Plan when to stop. Set a time, distance or number of repetitions that is realistic. A planned pause can help prevent an unhelpful cycle of overdoing activity and then needing prolonged recovery.
Build gradually and flexibly. When the current amount feels manageable and recovery is acceptable, increase one part at a time—such as duration, frequency or resistance. There is no single percentage or timetable that suits everyone.

Use symptoms as information, not a pass-or-fail test

Some people notice a temporary increase in pain when they change or increase activity. A small, short-lived increase does not automatically mean that harm has occurred. Pay attention to the pattern: what you did, how symptoms changed during the activity, and how you felt later that day and the next day. If symptoms keep rising, the activity becomes difficult to do safely, or you remain substantially worse afterwards, reduce the duration, range, speed or resistance and try a smaller step next time.

Try not to use pain alone to decide whether an activity is safe. Equally, you do not need to push through severe or escalating pain. Your diagnosis, health history, functional changes and recovery all matter. Ask your GP or physiotherapist for tailored advice if you are uncertain.

What to do during a flare-up

A flare-up is a period when pain or other symptoms temporarily become more intense. It can happen after a change in activity, poor sleep, illness, stress or for no obvious reason. A flare can be unsettling, but it does not always mean that your condition has deteriorated or that you have caused new damage.

Pause and reassess. Look for a clear change from your usual symptoms or a new problem that needs medical review.
Adjust rather than abandon everything. For a short time, use an easier version of the activity, shorten it, change position or spread it across the day. Keep comfortable movement and essential routines where you can.
Return in steps. As the flare settles, resume from a manageable amount and build back towards your usual activity. Avoid trying to make up for missed activity all at once.
Review the plan. If flares are frequent, prolonged or increasingly limiting, a clinician can help look at activity patterns and other contributors, and adjust the plan with you.

Make activity work in real life

Choose accessible options. Use supportive footwear, a stable route, a chair or handrail, or water-based exercise if these make movement more comfortable or safe.
Add movement to routines. Stand and move between tasks, take a short walk after a meal, or do a few gentle movements while waiting for the kettle. Small amounts count.
Protect recovery. Plan activity around sleep, work, caring responsibilities and treatment. Regular meals, hydration and rest breaks can support participation.
Track function as well as pain. Notice whether you are walking further, completing a task more comfortably, sleeping better or feeling more confident. Progress may show up in these ways even when pain remains.

When to get advice

Book a GP or physiotherapy assessment if pain is restricting daily activities, sleep, work or exercise; if you are unsure how to move safely; if flare-ups are frequent; or if your symptoms are not changing as expected. A physiotherapist can assess movement and function, discuss what may be contributing, help set an appropriate starting point and progress activity around your goals. Your GP can review medical causes and coordinate other care when needed.

Seek urgent medical care for new or rapidly worsening symptoms, such as progressive limb weakness, new loss of bladder or bowel control, numbness around the groin or saddle area, or severe pain after a significant injury. Call 000 for symptoms that may be an emergency, including chest pressure with severe breathlessness, fainting or feeling acutely unwell.

A note about delayed symptom worsening

If physical or mental activity causes a delayed and prolonged worsening of symptoms—sometimes called post-exertional symptom exacerbation—do not follow a standard graded exercise plan without clinical guidance. This can occur in conditions such as ME/CFS and some post-viral illnesses. Seek advice from a clinician familiar with your condition so your activity plan accounts for your response.

How Strides Health Group can help

At Strides Health Group in Narre Warren, adult physiotherapy starts with understanding your symptoms, health history, daily demands and goals. We can help you find a realistic starting point, adjust activities, build movement or strength gradually and review your progress. Where appropriate, we can coordinate with your GP or other health professionals.

Arrange an adult physiotherapy appointment or call 0411 876 851.

Download the staying active with persistent pain handout (PDF)