A different way to look at pain: building hope in your self-management

by Tory Garnham, Learning and Development Manager at Arthritis NZ 

When pain feels unpredictable, having a way to think about your next small step can make all the difference.

While attending the NZ Pain Society conference, I had the opportunity to speak with Nick Allan from Mastering Mountains Charitable Trust, Nick is someone who lives with fibromyalgia and Functional Neurological Disorder (FND).

During our conversation, he shared the idea of Hope Theory, something he brings into his work as a mentor and coach, and into the kaupapa at Mastering Mountains Charitable Trust, where he is a manager and trustee. It resonated with me not as a “quick fix” for pain, but as a practical way of finding a sense of choice and possibility within it.

I wanted to share this with you, our community, in case it resonates with you too. As the team at Arthritis NZ continues to refresh our pain information and resources, keep an eye on our website over the coming months for practical tools and support.

Hope isn’t about “just staying positive.” It’s a way of thinking that helps guide action.  

Hope is about how we:
•    set meaningful goals
•    find a way forward
•    and back ourselves to take the next step

Hope offers us a way forward. This can be especially helpful when navigating arthritis or long-term pain, and on those days where we feel adrift or powerless.

Hope theory can be broken into three parts: 

• Goals – what matters to you 
  Hope centres on goals that give us meaning. These can be small, like getting out for a short walk with your whānau, or bigger, like reaching retirement well and having the energy to spend time with your grandkids.
• Pathways – finding different ways forward 
  Pain can be unpredictable. What works one day might not work the next. Hope, as a way of thinking, helps us navigate change and find a path forward.  Sometimes, this means approaching challenges with a new or different perspective.
• Agency – your “I can do this” 
  Fostering hope is about building confidence in our ability to take even the smallest step on the hardest day. Knowing we can find a path and move toward our goal, however slowly can make all the difference. 

Example 1: Movement and pain
Walking with a close friend each week brings a lot of meaning, but it can flare your pain. Your goal is to stay active and enjoy that time together. Instead of stopping altogether, you try different approaches, taking a break halfway, doing water-based exercise, or finishing with gentle stretching at home.
That’s pathways — finding another way forward.

Example 2: Low energy days
You’re feeling tired, and everything feels like too much, but your goal is to do at least one act of self-care each day. Instead of giving up, you choose one small thing, taking five mindful breaths, doing a few minutes of gentle movement, or a grounding exercise.
That’s action — one small step that still supports your wellbeing.

Example 3: Building confidence over time
With each step, you start to notice what helps: pacing yourself, planning your week, or asking for support. You remind yourself, “I’ve done this before, and I can do it again.”
That’s agency — trusting that you can respond, even when things are difficult.

On a tough day, you might ask yourself:

• What matters most to me right now?
• What is one small step I could try today?
• If this doesn’t work, what’s another option?
• When have I managed something like this before?
• What positive emotions will I feel when I have taken this step?

There is no one “right” way to manage arthritis pain.

Having a way to think about where you’re going, how you might get there, and trusting your ability to take the next step, can make things feel more manageable. I hope this brings a sense of direction, purpose, or even small moments of joy into your everyday routine.

A big shout out to Nick Allan at Mastering Mountains Charitable Trust. Thank you for sharing your whakaaro and lived experience, we’re looking forward to hearing more from you as we continue to create and share content in this space.

You can find out more about Mastering Mountains here: https://masteringmountains.org.nz