It happened again.

After coaching a rec soccer game, the walk up the stairs brought it on instantly — back seized and locked up. And with it came that familiar sinking feeling:

“Not again. I was doing so well.”

And it had been going well. This was about two years without a major flare-up, roughly four times longer than the average through most of the previous decade. After dealing with low back pain for over 20 years due to congenital spinal stenosis and previous injuries, the warning signs had become recognizable. This time, they were noticed. Caution was taken. It still happened.

But here’s what matters.

When you’re in pain, stuck, or feel like you fell off track — especially if it’s happened before — it is so easy to feel like this is how it’s going to be from now on. Forever.

That pattern shows up constantly with people dealing with chronic pain or conditions like POTS or RA, but also with tendonitis, a tough week at work that wrecked a workout streak, or a stressful stretch that pulled someone off track with food.

The thought sounds like:

“Here we go again. I just can’t keep this up.”

But that’s not true. It just feels true in the moment.

The evidence almost always says something different. That’s exactly why reframing internal dialogue matters — because left to its own devices, the brain will happily ignore every piece of evidence that doesn’t match the “I’m doomed” story it’s telling.

What to Remember When a Setback Hits

✅ You’re more of an expert on your situation than you realize.

By this point, you’ve found some things that help. Or, almost as valuable, you’ve found things that don’t help. Either way, the pool of unknowns is shrinking. That’s progress, even when it doesn’t feel like it.

For example, dealing with a back flare-up means knowing that short, repeated efforts of gentle movement throughout the day help manage pain and restore function. There’s no single “magic” exercise, and what the body needs each day will vary — which requires patience to figure out what will feel good today. That used to feel overwhelming. Now it’s just the process.

✅ Every flare-up has taught something.

Sometimes it’s physical — a movement to avoid, a movement that helps. Sometimes it’s mental — a story that keeps coming up that isn’t actually serving you. Sometimes it’s simply more empathy for others dealing with chronic pain and challenges. Walking away from each flare-up with at least one new piece of the puzzle is the goal.

✅ You can’t rush it. You can’t force it.

This is the hardest one. There’s a natural pull toward wanting a timeline — it creates a sense of certainty and control when feeling most vulnerable. But sometimes the most important step is surrendering to the process and refusing to pile guilt, fear, or anxiety on top of what’s already a tough week.

”Surrender” Doesn’t Mean “Do Nothing”

You can’t rush the process, but you can always find your NAW — your Next Available Win.

Not the giant comeback plan. Not the “I’ll get back to 100% by next Monday” pressure. Just the next small thing you can do right now that interrupts the spiral.

During one recent flare-up, the NAWs looked like:

  • Getting on the heating pad
  • Sending a message to the doctor
  • Spending 5 minutes on the floor doing some gentle movements
  • Journaling out the spinning thoughts so they weren’t just rattling around

None of those things “fixed” anything. But each one shifted the dynamic from being acted on by the situation to taking one small action inside it.

Your NAW will look different depending on what you’re navigating:

  • Off track with food after a rough week? Your NAW might be jotting down an idea for your next meal, or falling back on a go-to meal when time and energy are short.
  • Missed a few workouts? Your NAW might be a 10-minute movement snack, not a full “I’ll do double tomorrow” comeback — that almost always backfires.
  • In a mental spiral? Your NAW might be writing it down, talking to someone, or grabbing something simple from your Nourishment Menu.

The flare-up is the flare-up. The story you tell yourself about the flare-up — and the next small thing you choose to do — is where the real control lives.

So if you’re in a hard stretch right now, whether it’s pain, an injury, a derailed routine, or just a season where everything feels harder than it should, know that this isn’t forever. You’ve come back before, and you’ll come back again. The only question worth asking right now is: what’s your next available win?