Learning to live to your unique health base-line is an important skill to develop to avoid the boom and bust cycle. This is called the art of pacing. It's a delicate balance when living with chronic pain, to manage daily life. Too much will cause more pain and fatigue, and too little may also cause more pain and fatigue. Living to your baseline gracefully doesn't mean you get it right all the time. There is always ebb and flow with chronic health that can be unpredictable. It is possible to pace life so that you can live well with with chronic pain and chronic fatigue. Read more about healthy and appropriate movements for chronic fatigue.

Pain is a very useful diagnostic. By training the skill of body awareness you become an expert on your own body. When you exercise the pain response lets you know that something is off in the body. There are many types of pain in the body, some relate to your condition and symptoms, some relate to physical alignment and how you hold your posture, and some relate to going passed your physical baseline and ability. Tai Chi and Qigong movements are "contained" within a safe range of motion and a well aligned posture. If you practice and experience pain, it is possible to pinpoint the source and adjust and adapt around the pain. You become an observer, rather than being reactive and jumping away from pain and stopping. This is part of changing your response to pain, to reframe how you experience pain so that you can exercise safely whilst leaning into chronic pain. Relaxing the body through mindful movements helps to lessen the pain experience as there is also a link between pain and physical tension. 

Learning the absence of resistance method when living with pain through mindful relaxation exercises is helpful to release both the mind and body whilst the pain remains. Tai Chi, Qigong and meditation practice are all healthy distractions that can help reduce pain levels. When your focus is elsewhere and you are doing something that is beneficial for your mental wellbeing and physical health, you start to build resilience. You no longer are thinking about the past or the future, or focusing on the pain you are in. Instead you are focused on slow and gentle movements or mindfulness exercises that activate your natural relaxation response. The more relaxed you can become when living with pain the better and the less you fight and reject pain the better. It's not a competition about whether pain wins or not, it's about finding ways to live well alongside pain. 

One of the most important things you can do when living with chronic pain is learn breath work techniques. There is a link between breath work and mental health, physical health and physiological health. Knowing the how's and why's can help you regain some sense of control over your pain experience. Diaphragmatic breathing can help reduce stress levels by stimulating the vagus nerve, improving your wellbeing and ability to cope. Breathing properly also aids the function of the lymph system which helps remove toxins and detox the body. Breathing techniques can be done lying down, seated, standing or whilst moving like in Qigong. You can use breath work chimes to regulate your breathing, helping you relax quicker and deeper. It is the one thing you can do, when you are in a pain flare that doesn't involved much movement and is proven to help.

When living with chronic pain, there is no off switch and it can feel like a physical prison. Pain can have a devastating effect on mental health and can commonly cause feelings of anxiety, depression, anxiousness, stress, worry etc. Even to the point of cyclical thinking and over-thinking. Learning about the natural relaxation response vs the stress response will help you understand the triggers of stress and what you can do to combat that. Learn how to stimulate the vagus nerve which is responsible for the majority of your rest and digest state. Learn how to boost your happy brain chemicals naturally, serotonin, dopamine and endorphins. Learn how to aid the symptoms of low mood, anxiety and depression. Overall developing the skill of relieving stressors is an important part of chronic pain self care management.

How you hold yourself in your habitual posture matters. Know that a prolonged sedentary lifestyle and sitting for long periods is awful for your health. Learn to maintain a symmetrical posture and develop awareness to know when your posture is compromised. When you practice Tai Chi and Qigong, it is possible to keep the knees safe and to protect the joints as you move through a range of motion. Traditional standing practice is a great exercise to do daily to help you align the body better, returning your structure to a neutral position. Follow along with a 12 step course on YouTube to learn about the major joints in the body and how to align in a Tai Chi and Qigong way. When standing there are different layers to focus on, one at a time, read the list here. Improving your posture helps to protect the weak points and strengthen your problem areas. Worth doing daily!

The lymph system is the drainage system for the body, removing toxins and waste. When sedentary the lymph system struggles to function as there is no pump. Exercise is the only way lymph fluid can be pumped around the body. When living with chronic pain, exercise can feel like the last thing you want to do. Whilst going to the gym or running may be out of reach for your current health baseline, Tai Chi and Qigong are non impact effective methods to exercise safely and will help your lymph fluid pump. The lymph system is activated through diaphragmatic breathing and movement. The quickest way to detox is through exercise and not all exercise is equal.

Chronic pain is debilitating, and can be localised around the joints. It is important to maintain healthy joints as much as possible through exercise. Tai Chi and Qigong are non impact, which takes away the potential of aggravating the joints even more. The body mechanics in Tai Chi and Qigong work to expand and compress the joint system which helps draw in synovial fluid that lubricates the joints, whilst pushing out toxins and waste to send to the lymph system. The moves may look graceful and light, however there is deep internal manipulation and loosening of the joints that can be quite demanding. This includes a lengthening and releasing quality in the spine, with movements that flex and extend to keep the spine nourishes and the nerves that come off the spinal cord happy.

Maintaining a flexible and pliable body is helpful when living with chronic pain. Chronic muscular contraction and physical tension can increase your pain symptoms. Tai Chi and Qigong have gentle and powerful spiralling movements that promote elasticity, lengthen the connective tissue, release the fascia and help to soften in appropriate muscle use.  The principle is called fang song, where we apply relaxation to the structure whilst aligning the body and maintaining our structure. Relaxing muscular tension and releasing inappropriate muscle contraction. This is unique to Tai Chi and Qigong compared to other martial arts or movements practices like yoga and pilates. 

Training body awareness when you are in stillness or when moving and exercising helps manage pain. Knowing where your body is in space without using your eyes, known as proprioception or body sensitivity, helps you know when you are moving your posture out of alignment, or helps you know when you are holding yourself in a position that may cause you more pain. Without regular training these awareness skills are lost, as the neural pathways atrophy like muscles. This also applies to cross brain connectivity, where the body is moving in unsymmetrical patterns at different paces, speeds and ranges of motion.  If you have poor proprioception then your are at risk from trips and falls. Having awareness of your wellbeing, emotions and psychological state is also important. Knowing when to take time for yourself or when to seek help. Awareness of you physical and mental self is a life long skill. Take time each day to develop right brain activities that help develop awareness; not using your eyes to move your limbs, using your feeling brain to know the shape, texture and sensations in your limbs, joints, fingers, ears etc. 

Living with a different baseline from the norm is exhausting. Your mental wellbeing gets battered by chronic pain, and you can become raw and vulnerable from the symptoms. Your daily resources may be taken up with just getting through the day. It may feel like a daily struggle and like groundhog day, as there is no off switch or annual leave from your experience. Simply getting a good night's sleep may not happen, with chronic fatigue going hand in hand with chronic pain. Pain isn't friendly, yet the trap to fall into is to fight pain with internal conflict. To try and control pain, or push through, or become tense to shy away from pain. All these do, even though they are natural human responses to pain, is cause more pain and poor mental health.

A valuable tool is to learn mindfulness and meditation as a stillness practice to ease the symptoms of chronic pain. This is another healthy distraction that helps move your focus gently away from your pain experience. Many people misunderstand what meditation is and believe it is out of their reach, explore the myths of meditation here. Find out about different types of meditation practice, it is trial and error to find a practice that resonates with you. Your automatic relaxation response, known as the parasympathetic nervous system doesn't mind which one you practice, as long as it is regular! And frequency over duration. From simple breathing meditation practices, to meditating on love, to Taoist practices that cleanse the organs and body scanning and physical relaxation techniques. There are thousands of traditional, modern and new age techniques. It is not one size fits all.