Why does my pain vary from day to day?
The most recent definition of pain from the International Association for the Study of Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”
There are several things to draw from this definition, but one is that emotions, as well as your cognitive and physical load, can lead to symptoms or amplify them. This means that there are other factors that can influence pain from day to day.
The ‘overflowing cup’ analogy can help us explain fluctuations in symptoms. Pain occurs when the cup overflows, so the more water we have in a cup, the closer we approach a point or threshold where we might experience spilling over the top. Additionally, if we are always near the top of the cup, there is less room and tolerance to life’s daily demands without causing a symptom flare. With our modern understanding of pain science we know many things can influence someone’s pain experience.
What can fill the cup?
Large, sudden or even gradual changes in weekly stress levels
Inadequate sleep or sleep quality
Health conditions (i.e. diabetes, high cholesterol, and hypertension)
Little social engagement
Difficulty participating in meaningful activities
Fear or worry about one’s health condition
If we start to add up some of those variables, plus continue to take on the general day-to-day activities, the body is less capable of tolerating and coping with all the demands. All of these things have the potential to influence the sensitivity of your pain and because life demands continually change, so do the symptoms.
Despite the complex nature of pain, there are many things you can do to create more room in your metaphorical cup.
First, you will need to identify some of the factors that could be taking up some cup capacity. If stress is one, there are several stress management strategies that could be helpful. Or, if sleeping has been an issue, perhaps sleep hygiene could be discussed. Additionally, your physiotherapist will provide education about your condition and provide a road map on how to overcome it, which will reduce some fear or worry of non-recovery.
The goal is to determine what could be contributing to your symptoms and then to modify the variables to improve the body’s capacity to cope with life demands.
If you need assistance identifying what could be contributing to your symptoms, ask your physiotherapist for further information and build out a plan of care.
By Ali Alexander, Physiotherapist