« J'ai mal, je ne peux plus faire » : quels sont les obstacles face aux activités quotidiennes et comment les dépasser ?

Chronic pain prevents the patient to do as he was used to. It requires lifestyle changes and this will cause resistances and a myriad of emotions going as far as to self-doubt. But all patients are not acting in the same way. We now know that there are different patterns of activity: modulating, avoiding and persisting. If common sense offers good tracks to do otherwise, it is not sufficient. What are the issues which make it so difficult for the patient to maintain a daily life as normal as possible ? We'll discuss some obstacles by seeking to understand and providing therapeutic strategies useful to overcome them. Among the barriers, which can lead to avoidance of activities, the most studied is with no doubt the fear of getting hurt by such movement or such activity. But there are also other fears, like the judgment of others, because pain often requires behaving against social uses. The high standards are another barrier. It could underpin the persistent behavior. The patient wants at any price, doing according to its standards despite the pain. Exposure, behavioural experiments and problem solving are particularly interesting therapeutic strategies in this context. Chronic pain largely reduces patient's quality of life and makes it lose its sense. Identify beliefs and barriers to activity is an essential first step, in order to adapt treatment whose goal is helping the patient to regain his life.