Managing chronic pain and improving your quality of life aren't things you can achieve overnight. Even if you have made changes to your daily routine, you still may worry about what will happen weeks or months from now. How can you maintain the progress you're making? What happens when you're confronted with a difficult day?

No doubt, you will have some difficult days. And there may be times when you catch yourself reverting to old habits. No one is perfect. However, you can lessen the effects of these occasional setbacks by developing strategies that help keep you on course to an active and rewarding life.

10 ways to stay in control
The best advice for staying in control of your pain is to regularly use pain management strategies, such as exercise, relaxation and pacing yourself. The more you use them, the more beneficial they'll become.

To maintain your progress and avoid relapses:

1. Follow through on your goals. Focus on your areas of greatest concern. Then set some specific, measurable and realistic goals to help you deal with those issues. For each goal, be sure to break your journey into small, achievable steps. Create a checklist, and put an X by each step you reach. To help strengthen your motivation, ask a family member or a friend to periodically review your checklist.

2. Monitor your progress. Seeing the accomplishments that you've made can motivate you to continue toward your goals. Use charts to display your progress.

3. Write out a contract. Some people find that making a personal commitment to improving their lives and managing their pain helps in following through on their plans. More than just a goal, a contract becomes a pledge associated with other binding agreements you've made throughout your life.

4. Plan your day. When you specifically schedule time for something — such as exercise or going to a movie — you're more likely to do it. Also use to-do lists or notes on a calendar to remind you of your priorities.

5. Control your surroundings. Look around your house and change things that might lure you back into unhealthy habits. Is your bed still sitting in the living room so that you can avoid the walk upstairs to your bedroom? Are the drapes pulled to keep your rooms dark? Make your house feel like a home, not a hospital or a mortuary. When you walk around your house, you want to see evidence of a person who lives a happy and active life.

6. Seek and accept support. Accepting help from others isn't a sign of weakness, nor does it mean that you're failing. You need support from others to keep you on track and to help you when you have difficult days. In addition to support from family and friends, consider joining a chronic pain support group.

7. Work with your doctor. Your doctor can be one of your biggest advocates. Keep your doctor updated on your progress and any obstacles you may encounter. He or she often can help you overcome those obstacles. If your doctor isn't willing to work with you, you may want to find a doctor who will.

8. Stay positive. List as many positive statements about yourself as you can and repeat them to yourself when you're feeling discouraged or in danger of slipping back into some of your old patterns of unhealthy behavior. If you do have a relapse, accept that setbacks sometimes occur. Take comfort in your past successes. They're proof that you've got the skills to succeed again.

9. Prepare for challenging situations. Make a list of situations that could disrupt the positive lifestyle changes you've made. Whatever they are, prepare a response plan that you can activate when needed.

Perhaps you've been walking for 30 minutes each day, but you know the weather soon will change and you don't like being outside in the snow or cold. How do you still fit in your 30-minute walk each day? One option might be to walk indoors at a nearby mall. Or, perhaps, a local school allows indoor walking during certain hours. You might also consider purchasing a treadmill.

If pain limits your exercise, ask your physician or therapist for alternatives. For example, swimming may have less impact on your joints than walking. A recumbent bicycle can place less strain on your back than a traditional bicycle.

10. Reward yourself. Rewards are a great way to reinforce positive change. When you reach a goal or successfully execute one of your pain strategies, treat yourself to something enjoyable — perhaps a movie, a sporting event or a massage.
Getting through a difficult day

Everyone has bad days now and then. Holidays can be difficult. Then there's tax time or unpredicted severe weather overnight. A visit from relatives also may qualify. Whatever the reason for your bad day, you can get through it.

One of the best ways to minimize the disruption and quickly get back to your usual activities is to plan for difficult days. Think through ways to cope with upcoming challenges when you're having a good day. Anticipating future difficulties can only make already bad day worse. Here's how to plan ahead for a difficult day:

• Identify the events and situations that make for difficult days. Knowing the most common reasons for your difficult days will help you better prepare for them. Think about some recent bad days. Was there a reason for your increased pain? Could it have stemmed from too much stress, overdoing it on the weekends, traveling or lack of exercise?
• Identify your warning signs. Do you get a warning sign when a bad day is headed your way, such as a headache, excessive fatigue or onset of the blues?
• Maintain a normal schedule. A difficult day is not a time to overdo it — or to do nothing. Lying around won't improve your pain or make the day go by any faster. Get out of the house. When you're hurting, it's natural to want to be alone. But this only gives you more opportunity to think about your pain. Go shopping or visit a friend who can keep you occupied.
  
• Seek other diversions. Read something enjoyable. Watch a funny movie or call a friend who has a good sense of humor.
  
• Try to relax. On a difficult day, spend more time practicing your relaxation techniques, such as listening to soothing tapes or practicing your breathing exercises.
  
• Use medications wisely. If you've weaned yourself from medication, don't let a bad day tempt you into taking it again. Remind yourself that it's only a temporary solution and that you're better off without it. If you're taking medication, don't change the dose in an attempt to reduce the pain. You only increase your risk of side effects, and the increased dose may not help your pain.

Overcoming barriers
Many people end up limiting their activities simply because they are afraid of worsening their pain. This type of thinking can result in self-fulfilling prophecies, as your body gets used to doing less and less. Negative thoughts also can color how you see your situation. Even minor problems can appear catastrophic, making it all too easy to just give up.

These are very common reactions to chronic pain, and it may be very difficult to overcome them on your own. You may want to consult a mental health counselor. These professionals can help you learn to break negative patterns of thinking.
Be patient with yourself and your situation as you learn to use these strategies. It's hard work to reclaim the life stolen from you by chronic pain. But the results are well worth it.

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