Footstep 8

Food, relationships and work

Eating well and having a normal-range weight will help you to build better health and cope well with pain.

Connecting and doing things with other people is likely to lift your mood and distract you from focusing on your pain.

Staying at work or returning to work gives your life routine, structure and purpose.

Healthy eating

Being overweight gets people down and affects at least 50% of people with pain. Key tips from people with pain are:

Do not do yet another weight reduction diet

It can make you feel low even thinking about it!

Medications for pain can lead to you putting weight on

This is unhelpful and makes managing pain trickier. So explore options including a medications review with your doctor or pharmacist.

Try and go Mediterranean instead!

Eat more healthy food like pasta, fish, lentils, chicken, vegetables and fruits as these helps joints, muscles and nerves work better. Use olive oil as your main cooking oil as it is healthy oil. Explore more about these foods known as the Mediterranean diet, on www.nhs.uk/

Healthy eating doesn't just help you lose weight

It also reduces your risk of heart disease, stroke, dementia, cancer, and constipation as well as depression and anxiety.

Low Vitamin D is linked to persistent pain

It's sensible to take daily supplements as levels can often be low in people with pain. Sunlight helps your body produce Vitamin D, but getting enough is difficult in winter or if you're indoors a lot. Check with your clinical team and explore NHS Choices to discover more.

Never skip breakfast, as this helps the body be less stressed, tired – and painful!

Start with easy, small portions like two or three tablespoons of cereal or yoghurt or half a banana. People with pain who skip breakfast find eating very small portions is a good start to eating better. Fruit juices and water are healthy too and help reduce drinks with caffeine like coffee and tea.

Eat meals regularly with small portions if you are quite inactive

Snacks can be tempting but unhelpful for managing weight and pain!

Janice’s breakfast

Janice hated breakfast, especially if she had been up at night with her neck nerve pains. So she just had a mug or two of coffee. Then side effects of pain medications meant she skipped lunch. Late afternoon she had some biscuits and a banana and felt very full.

When she tracked her eating patterns Janice found she ate too much sweet food, often ate only once a day and felt really tired. She set a goal to eat breakfast, just two tablespoons of muesli and one tablespoon of yoghurt.

Janice ate breakfast most days and within two weeks she found she ate more, was less tired and grumpy. Her next goal was to have soup at lunch time and continue her small breakfast. This helped her day routine and she had more energy, better concentration and helped her fitness plans.

Three months on “I have lost 10 lbs just with smaller portions and eating better... it feels good.”

Managing relationships - connecting better with others

Connecting with others can feel like the last thing you want to do when pain dominates your life. Yet doing things with other people is likely to lift your mood and distract you from focusing on your pain. It can also motivate you to do more of the activities you enjoy.

Explaining your experience to others

It can help to let people know how the pain limits you. Other people can’t see the invisible effects of pain. So talk to them about ways they can support your goals or help you live better with pain.

Help with relationship difficulties

Difficulties with partners and family members may need support from others and there are organisations that can help (see resources, below).

Sometimes young people who are caring for you can also be supported with local young carer schemes.

Staying or returning to work

People find being in work a good experience in many ways including helping routines and getting to know more people. They found they coped well with some difficult times on their route back to work or study. New coping skills used to manage pain helped work and other roles, especially pacing the work load and managing moods, like frustration. Some tips:

Think what needs to happen for you to return to or stay at work

and build it into your goals (see Footstep 3 – Setting goals for more on how to set and reach your goals)

Be flexible on what and when you might work and where

For example, volunteering lets you explore new possibilities without the same level of demands as a paid job.

Ask your employer for a phased return to work

People living with persistent pain do return this way successfully. If you can, start with just two or three hours per day for the first week and steadily build up from thete. This has helped many people back to work.

Make use of what's on offer

If you're offered support, occupational health, retraining programmes or adaptations or aids – accept them!

Get professional support

Get your physiotherapist or GP on board to support you in returning to work.

John’s story

John went to local community college – due to benefits pressures, he was left with little choice and took the plunge.

John had really struggled with reading and writing at school. The college was good fun and helpful. He discovered people like him were also finding out what they could do through job skills training and experience, like business studies, running a retail shop, learning upholstery or electrical maintenance.

He did some diploma courses and was thrilled to pass them. He found work within two months after a college work place in a garden centre as assistant manager.

He realised he had struggled too long before taking the plunge: “do not wait, give training or new work a try and get good advice.”

Resources for you to use

Interactive guide to eating well

Explore the NHS guidance on eating well with this interactive online guide

Relationships – a guide

Overcoming Chronic Pain, a self help book by leading pain experts including the author of 10 Footsteps, has a useful chapter on relationships for people with persistent pain.

Coping with work and study with chronic pain

Short videos of real people with persistent pain, sharing their experiences of coping with work and study, from Healthtalk.

Food, relationships and work: key ideas

  • Eating well and having a normal-range weight will help you cope better with pain
  • Doing things with other people is likely to lift your mood and distract you from focusing on your pain
  • Staying at work or returning to work is especially important for people with pain as gives your life routine, structure and purpose