Persistent Pain Management

For patients with delayed flare-ups, total session volume should be managed rather than only in-session pain. For patients with pain at rest, exercise should stay within the established baseline pain level rather than require zero pain. Pain during a movement can become learned through neurological tagging that associates the movement with pain. Pushing patients through pain during movement tasks is not recommended. Total avoidance of daily tasks can lead to deconditioning and worse flare-ups when the task becomes unavoidable. The article recommends coaching movement before changing exercises or otherwise progressing.