The Boom and Bust Cycle: When Good Days Lead to Crash Days

Dr Senadheera
Jun 12
4 min read

Updated: Jun 24

If you live with chronic back pain, this might sound familiar:

One day, your pain feels manageable. Your energy returns—finally!—and you rush to tackle everything: laundry, errands, a workout, maybe even some long-delayed tasks at work or home. For a moment, you feel like yourself again.

Then comes the crash.

Your pain flares up.

You feel wiped out, sore, and stuck in bed—or at the very least, not functioning at your best.

This is the Boom and Bust cycle—a common and frustrating pattern among people with persistent pain. It’s especially common in women who carry multiple roles: caregivers, professionals, mothers, partners. You push through on the good days… and then your body pushes back.

Let’s unpack why it happens—and how to start breaking the cycle.

What Is the Boom and Bust Cycle?

The Boom Phase

On a “better” day, you feel a glimmer of energy. Pain has eased enough that you want to catch up. You dive into:

Cleaning or errands
Physical activity
Work deadlines
Family responsibilities

It feels good—liberating, even—to get things done. But this “boom” often involves pushing beyond what your body can comfortably handle at the moment.

The Bust Phase

Then comes the backlash. Sometimes within hours, sometimes the next day:

Pain increases
Muscles stiffen
Fatigue hits hard
You feel emotionally drained

This is your body asking for rest—sometimes demanding it. The crash may last days, or longer. Over time, these swings can weaken muscles, increase sensitivity to pain, and prolong recovery after each flare-up.

Why It Happens

The cycle often starts with overexertion during those windows when your pain eases and you finally feel more like yourself. It’s natural to want to make the most of those better moments—catching up on life, getting through chores, or enjoying movement again.

But even when it feels doable, pushing too far can stretch your body beyond what it's ready for. Pain may be low, but energy is still limited. When you go beyond those limits, your nervous system can quickly feel the strain, leading to a flare-up—more pain, more fatigue, and more frustration.

Many women know this cycle all too well. The desire to keep life running smoothly—at work, at home, in relationships—makes it hard to slow down. That’s why, when a good day comes along, it feels like an opportunity not to be missed. But trying to do too much too quickly often makes the next few days harder, not easier.

Breaking the Cycle with Pacing

The Boom and Bust cycle is not just a personal struggle—it’s a recognised pattern in chronic back pain. Self-management strategies like pacing are now widely recommended in both national and international guidance for managing long-term pain (1,2). These approaches help people live better with pain by focusing on what’s possible—rather than pushing through or waiting for pain to disappear entirely.

Alongside pacing, many people also benefit from support such as physiotherapy, psychological strategies, or taking part in a structured pain management programme. These programmes—available in many countries—are based on a holistic or whole person model of care, which recognises that pain is influenced not just by physical issues, but also by emotional wellbeing, stress, and social factors.

Improving sleep, reducing fear of movement, and building emotional resilience are just as important as physical strategies. These are the foundations of modern, evidence-based pain care around the world (1).

The key to escaping the Boom and Bust trap? Pacing.

Pacing isn’t about doing less forever—it’s about finding a way to stay engaged with daily life without overwhelming your body. It’s a method that helps you move forward gently, without triggering flare-ups or needing days to recover.

5 Small Ways to Start Pacing

Tune into your body — even on good days. Pain might be down, but your energy has limits.
Break big tasks into smaller ones — spread them across the week rather than one afternoon.
Plan regular rest breaks — not just when you're tired, but before.
Let go of guilt — rest isn’t lazy; it’s preventative care.
Speak up — explain pacing to your family, employer, or friends so they can support your needs.

Pacing helps reduce central sensitisation—the phenomenon where the nervous system becomes more reactive to pain over time. This means that everyday activities or mild discomfort, which wouldn’t normally cause intense pain, can begin to trigger significant discomfort. The nervous system essentially becomes hypersensitive, amplifying pain signals and making recovery more challenging. Research shows that pacing can support daily function, reduce emotional distress, and limit flare-ups in people living with persistent pain (3).

This Isn’t Laziness—It’s Smart Management

Living with chronic pain means learning to work with your nervous system, not push against it. It takes time, patience, and a shift in mindset—but finding a steadier rhythm can help you feel more in control of your days.

You don’t need to do everything at once. You just need a pace that fits where you are right now—one that allows room to recover, rebuild, and ask for support when needed.

Let’s Hear From You

Have you experienced the Boom and Bust cycle with your back pain?

Yes — I go through it all the time
Maybe — I’m starting to notice a pattern
No — but I’ve heard others talk about it
Not sure — I’m still figuring it out

Your voice matters.

Your answers help us create more tailored resources for women living with back pain.

References

British Pain Society. Guidelines for Pain Management Programmes for adults. London: BPS; 2021. Available from: https://www.britishpainsociety.org/static/uploads/resources/files/book_pmp_2021_FINAL_3.pdf
National Institute for Health and Care Excellence (NICE). Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain. NICE guideline [NG193]. London: NICE; 2021. Available from: https://www.nice.org.uk/guidance/ng193
Nielson WR, Jensen MP, Karsdorp PA, Vlaeyen JW. Activity pacing in chronic pain: concepts, evidence, and future directions. Clin J Pain. 2013 May;29(5):461–8. doi:10.1097/AJP.0b013e31826f4a09.