Els always loved to go cycling. Since the failed operation after her herniated disc it has not been possible to cycle. It hurts too much, getting on the bike is difficult and Els is afraid that she will fall - and then hurt her back even more. She hasn't been cycling for a number of years.
If you are in pain for a long time, your brain is getting better at 'creating' pain! That may sound a little strange, but when you think about it, it's not so bad. Just think about it, you always get better at things when you do them for a longer period of time. When it comes to cycling, chess, running or arithmetic. The more you do something, the easier it is for you to go off.
In case of pain this is rather annoying. It can make you feel pain much faster and more often under conditions that are completely normal for others. That walking, cycling, gardening, or even a gust of wind can hurt...
There is good news: This system can be undone. A proven effective way is to rebuild your daily activities very slowly and in doses. You can pick up activities that you enjoy, but no longer do, steadily.
Why enjoyable activities? Well, first of all because it's the most fun... but when we look at our brain, it has two more advantages.
1. Your brain makes new connections faster when you're having fun. And those new connections are important, because they will counteract the old 'pain connections'. Because you want to train the hypersensitivity of your brain as quickly as possible, it helps enormously if you succeed in doing so in a way that gives you pleasure. It will also be easier for you to keep it up for longer.
2. It's harder for your brain to be in alarm mode when you're having fun. Your brain interprets all kinds of signals as 'danger' when you feel pain. In the case of chronic pain often completely unjustified, because there is no danger at all and you still feel pain! Having fun from before your brain is difficult along with 'danger'. Real danger and pleasure just don't go well together.
So... when you look at your own life, are there activities that you avoid, but that would give you a lot of pleasure or did so before? Will you be able to practice in small steps?
In the case of Els, she realized that she would love to cycle again. The step to cycle had become so big and scary that she decided not to do it again. She was also disappointed in herself, because she used to cycle 50 kilometres like this and now she wouldn't be able to. In the end Els and her physiotherapist first practiced getting on the bike and getting off. When she felt more sure about that, she slowly started to expand. She now cycles 5 kilometres a day, but that took two months! Still, Els can enjoy the kilometres she does make.