Graded exposure and pacing, in plain words.

Graded exposure has three moving parts: a baseline you can hit on a bad day without a flare, a step size you can repeat for a week or two, and a review built into the next visit. The first visit measures the baseline (how long can you walk, sit, lift, train right now?) and sets the first step. Your therapist writes it down and you leave with a plan you can start the same week.

Pacing means doing the planned amount on good days, not the amount your mood allows. People with long-term pain have usually been through many good-day spikes followed by bad-day crashes. Pacing is a technical skill: not willpower, not pushing through, not stopping at the first discomfort. Your physiotherapist helps you set a stop rule that is boring enough to protect the next day.

A flare tells us the step was too big for this week, nothing more. The plan is not thrown out. It is dialled back one step, held for a few days, and started up again at the pace your system shows us it can handle. People who have been in the boom-and-bust cycle for months often need a few flares to trust that the plan survives them.