What To Do When Pain Flares Up

As you return to exercise or increase your movement, some soreness or small, short-lived increases in pain are normal and not a sign of damage. What we watch out for is sharp pain during a movement, or any of the red-flag symptoms below. Pain from a movement that subsides quickly is generally not a concern and can be handled with activity modification (see the regressions for each exercise in the library).

In general, if your back flares up, keep gently moving in ways that don't clearly provoke your pain further. Resting from heavier activity (other than walking) for a couple of days is often helpful, but keep some comfortable walking with frequent short breaks or decompression positions so you don't become completely inactive.

If your pain flares up, here's what to do

1. Don't panic.
2. Evaluate the situation.
   • Mild pain / soreness (no red flags): continue with the program and exercises.
   • Moderate pain (no red flags): find what you can do that isn't painful and drop the rest for 2-3 days. Keep walking. Take breaks if you must, but keep walking; movement is crucial. If pain settles after 48-72 hours (or doesn't escalate), return to the full program.
   • Severe pain (no red flags): maintaining movement is very important, and walking is the best way to do it. Move with stability, not rigidity. Look after your well-being and daily needs. If you can't perform daily tasks and the pain isn't subsiding within 1-2 weeks, seek medical care.

Red-flag symptoms

Seek medical care immediately if you experience:

• New bladder or bowel problems
• Numbness around the saddle / groin area
• Rapidly worsening leg weakness
• Feeling physically unsafe

The traffic-light rule

A useful framework for judging pain during exercise:

• Green (0-3/10): safe to continue
• Yellow (4-5/10): acceptable if the pain subsides soon after finishing
• Red (6+/10): stop and modify the exercise

The pain guideComfortable0-3 out of 10Keep going. This is the zone we work in.Noticeable4-5 out of 10Okay to continue if it settles soon after you finish.Time to ease off6+ out of 10Switch to an easier version today. That still counts as showing up.Soreness is information, not damage. Use these zones to adjust, never to judge yourself.

This educational content does not constitute medical advice. For diagnosis or treatment, please consult a clinician.