Goal Setting for Pain

How to start making personalized goals

Goal Setting

Goal setting for chronic pain management may not be on the top of your mind. However, research has shown that many areas of your lifestyle affect the experience of pain, and that small changes can make a difference in your ability to do what you need and want to do despite your pain. Goal setting is an effective tool to change behaviour.

A goal is something you can check off a list. Goals can be achieved and involve concrete actions.

When you think of your pain and goal setting, think of how do you see a better life? This may guide you in what area you would like to focus on first to make changes.

You can get started by asking yourself, “If my pain was managed well, what would be different? What would I be doing more of? What changes would other people who know me notice? What is most important to me at this time?”

Goal setting can help you:

  • know if you are living according to your values.
  • help you stay organized.
  • help you stay motivated.

Setting small, meaningful, SMART goals can help you see more successes.

Key concepts:

  • Steps to effective goal-setting.
  • How to start making personalized pain goals.

Setting a SMART Goal

A goal is something you can check off a list. Goals can be achieved and involve concrete actions. When you think of your pain and goal setting, think of how do you see a better life? This may guide you in what area you would like to focus on first to make changes. Think of what your overarching goals for pain management are. Make sure your goal areas are around activities and something that involves an action. This means your goal can’t be “get rid of pain” or “reduce my stress”. Think about what activities you will need to do so you can work toward these states of being, if that is important to you. Better yet, think about what activities will increase your quality of life. What do you need to do or want to do?

Some examples include:

  • Improve my sleep
  • Move my body more
  • Have more fun in life
  • Learn skills to relax
  • Specific: List the actions needed to work on this goal.

    When formulating a specific goal think about the following:

    • Who, what, when, where and how
    • Name your goal: I want to…
    • Make it more detailed: What exactly I am going to do:
    • Describe the way you’ll do it: How am I going to do it?
    • Name a location: Where I will do this…
    • Name a time of day/week: When I will do this...
  • Measureable: Put a number on it.

    When formulating a measureable goal think about the following:

    • How are you going to measure this goal?
    • How will you know you are making progress?
    • How will you know when you have achieved your goal?
  • Attainable: Make a change you are confident about achieving.

    When formulating an attainable goal think about the following:

    • Make a change you are confident about achieving: 
    • Think about what motivates you to change this and why:
      • List the values you hold that are related to this goal: health, balance, creativity, family, etc.
    • Meet yourself where you’re at now:
      • It can be difficult when a prior goal is no longer realistic. For example, 10 years ago your goal may have been to run a 5K race, but this may no longer be attainable at this time.
      • Be kind and compassionate with yourself (think: what would I say to a loved one if they were in my shoes?).
      • Be honest with yourself.
    • And remember: “small wins” today help build motivation so you can build up to larger goals in the future!
  • Realistic/ Relevant: How realistic is your goal?

    When formulating a goal that is realistic/relevant think about the following:

    • How realistic is my goal?
      • List the actions you need to take to work on this goal. These should be specific as well.
      • Think of challenges, barriers, or obstacles to achieving your goal. Come up with at least two solutions for each challenge.
    • Your goal should be linked with pain, but with a focus on function rather than pain level.
    • Start by considering what issues in your life influence your own chronic pain pathway/alarm system:

  • Time bound: What is the timeline for your goal?

    When formulating a goal that is time bound think about the following:

    • Set a date to start working on the goal (the first action from the “realistic” stage).
    • Set a date to check-in with yourself and ask:
      • Is my goal still SMART, or do I need to tweak it?
      • Am I making progress? Why or why not?
      • Do I need to ask for help?

Key concepts:

  • The acronym SMART can help you make effective goals. when setting goals remember to set ones that are:
    • Specific
    • Measurable
    • Attainable
    • Realistic/ Relevant
    • Time bound

Step by Step guide to set a SMART goal.

Let’s go through an example together, with the initial goal:  “I want to be more active!”

Getting Started: Download TAPMIs Goal Setting Worksheet

Setting a SMART Goal Step 1: Be specific about what you want to do, thinking about what, how, where and when.

  • Name your goal: I want to…
  • Make it more detailed: What exactly I am going to do:
  • Describe the way you’ll do it: How am I going to do it?
  • Name a location: Where I will do this…
  • Name a time of day/week: When I will do this…
  • Example:

    I want toImprove my walking.

    What I am going to do (be specific): I am going to walk standing upright with good posture.

    How am I going to do it: With my friends, do some stretching exercises to warm up and prepare.

    Where I will do this:  Around my neighbourhood.

    When I will do this:  Saturdays - every week in the afternoon at 3pm.

Setting a SMART Goal Step 2: Determine how you will measure your progress.

  • How are you going to measure this goal?
  • How will you know you are making progress?
  • How will you know when you have achieved your goal?
  • Example:

    How I will measure this to see my progress: (Amount, # minutes, # days per week):

    5 minutes at a time (starting point) - add 10% per week.

    Week 1: 5 minutes

    Week 2: 5.5 Minutes

    Week 3: 6 minutes

    Week 4: 6.5 minutes

    Week 5: 7.25 minutes

    Week 6: 8 minutes

    Week 7: 8.75 minutes

    Week 8: 9.5 minutes

    Week 9: 10.5 minutes

    I know I will have achieved my goal when: I can walk for 20 minutes.

Setting a SMART Goal Step 3:  Rate how confident you are that you can do this, and how important it is to you.

  • If you are less than 70% on either, choose a new goal or revise this one.
  • List the values you hold that are related to this goal: why is this goal important to you?
  • What is the meaning of this goal?
  • Example:

     

    The values related to my goal are (why this goal is important to me):

    1. To be able to travel.

    2. To be able to keep up with friends and be social.

    3. To have fun.

Setting a SMART Goal Step 4: Ensure your goal is realistic.

List the first few actions you need to take to work on this goal. These should be specific as well.
Think of challenges, barriers, or obstacles to achieving your goal. Come up with at least two solutions for each challenge.

  • Example:

    The first 3 actions I will take to achieve this goal are (be specific):

    1. Pick a day to be the starting day.

    2. Take a book so I can read and have a coffee at the end of my block (5 minute walk).

    3. Call a friend to join me.

    Here is how I will cope with challenges while working on this goal:

    Challenges  Solutions
    1. Family Obligations- people needing me for things.
    •  Learn different ways of saying "no" eg say, "I'm committed".
    • Remind myself that taking care of myself helps my family as well.
    • Share my goal ahead of time so they know it is important to me.
    • Put it in my calendar and do not schedule over it.
     2. Sticking to the time for myself
    • Remember it is a priority.
    • Look at my list of values.
     3. Pain
    • Keep doing my stretches and deep breathing.
    • Take more frequent breaks during the walk.
    • Remembering to take my medication as prescribed.

     

Setting a SMART Goal Step 5: Set a date to start working on the goal and set a date for checking your progress.

  • Example

    I will take the first step on this date: February 1.

    I will check my progress on this date: February 15th. I will check my progress every 2 weeks.

Key concepts:

  • When goal setting remember that it is a process that is constantly evolving.
  • If you are less than 70% confident that you can achieve your goal consider adjusting your goal.
  • If you are not on track like you were planning revisit your challenges chart like designed above.
  • Ask a friend or family member to help you with your goal setting if you are feeling stuck.

Conclusion

Congratulations you have completed the goal setting module.  Self-management strategies are a necessary part of managing chronic pain.

Setting SMART goals for pain management helps to be successful at using self-management strategies. Remember managing your pain is a life long journey.

As you make changes in one area you will start to see improvements.Continue to use this module as you need over your life. 

 

References

  1. Butler, D. & Moseley, L. (2012). Explain Pain. Adelaide: Noigroup Publications.
  2. Butler, D. & Moseley, L. (2016). Explain Pain Supercharged. Adelaide: Noigroup Publications.
  3. The Explain Pain Handbook Protectometer
  4. Cai-Durate, B., Kircher, C., Moore, B. & Sheffe, S. (2018). Changing Your Pain Pathways: Ways to Cope with Pain in Everyday Life. Toronto: University Health Network
  5. Costigan, M, Scholz, J. & Woolf, C.J. (2009) Neuropathic pain: A maladaptive response of the nervous system to damage. Annual Review of Neuroscience.
  6. Louw, A. Puentedura, E. (2013). Therapeutic Neuroscience Education, teaching patients about pain. USA: International Spine and Pain Institute.
  7. Meeus, M., Nijs, J., Van Wilgen, P., Noten, S., Goubert, D. & Huijnen, I. (2016). Moving onto movement in patients with chronic joint pain. International Association for the Study of Pain.
  8. Miller, J. (2016). Chronic pain self-management support with pain science education and exercise. Webinar retrieved from www.cirpd.com
  9. Moseley, G.L. (2007). Reconceptualising pain according to modern pain science. Phys. Ther. Rev. 12(3):169–178. doi:10.1179/108331907X223010.

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