When you’re in the throes of an intense IC/BPS flare, you dream of getting relief. And then one day you wake up and something is different. Your symptoms have quieted down. They maybe haven’t gone away but they are more manageable.
So you do what any reasonable person would do. You seize it. You finally tackle the laundry that’s been piling up, run the errands you’ve been putting off, say yes to lunch with a friend, deep-clean the kitchen, maybe even garden a little. You’ve been waiting for a day like this, and you are not going to waste it.
And then, a day or two later, you’re flaring. Hard. You’re probably confused because you didn’t even eat anything different. Or you knew it was coming but pushed through anyway because you’re so desperate to get things done and feel relatively normal, despite the cost.
Yet this pattern of overdoing it on good days is one of the most common and least talked-about reasons. It’s a pattern that researchers in chronic pain call the boom-and-bust cycle, and for many people living with IC/BPS, it’s quietly running the show behind the scenes.
What the Boom-and-Bust Cycle Actually Is
The boom-and-bust cycle (sometimes called the push-crash cycle or “overactivity” in the research) describes a very human response to chronic illness. On a low-symptom day, you push hard to make up for everything you couldn’t do when you felt awful. The activity catches up with you, symptoms spike and you’re forced into a stretch of rest and recovery. When you finally feel better again, the cycle repeats.(1)
Researchers studying chronic pain have measured this pattern directly. In one study where participants wore activity monitors and tracked their pain several times a day, higher levels of overactivity were linked to greater swings in both pain and physical activity — bursts of doing too much, followed by significant increases in pain.(2)
Here’s the part that’s easy to miss: in most areas of life, pushing through and powering past discomfort is a virtue. It’s how we get ahead at work, finish what we start, prove we’re not “being dramatic.” But with a sensitized, chronic-pain condition like IC/BPS, the usual rules don’t apply. The harder you push through, the harder your symptoms tend to push back.
Why This Hits IC/BPS Patients Especially Hard
There are a few reasons the good-day trap is particularly sticky for people with IC/BPS.
Flares are unpredictable.
When good days are rare, they feel precious, and that scarcity creates real pressure to maximize every single one. The instinct to “get it all done while I can” is completely understandable.
Overexertion is a recognized flare trigger.
When researchers at one site of the MAPP Research Network asked IC/BPS patients what set off their flares, physical activities and overexertion showed up alongside the usual suspects of certain foods, stress and sexual activity.(3) Your body isn’t betraying you for no reason. It’s responding to a genuine load.
A sensitized nervous system has a lower threshold.
Many IC/BPS patients, particularly those in the neurogenic hypersensitivity phenotype, live with central sensitization, which is a state in which the nervous system has become amplified in its response to pain signals.(4) When the system is already running hot, it doesn’t take much extra input to tip it over the activation threshold. A big day of activity is exactly the kind of overload that can re-trigger the sensitization cycle.
So the “good day” that felt like a gift becomes the setup for the next flare. Not because you did anything wrong, but because the protective system in your body is doing its job a little too well.
The Trap Within the Trap: Underactivity
If overdoing it backfires, the obvious solution seems to be do less, rest more and avoid anything that might provoke symptoms.
But the research tells a more nuanced story. Both ends of the spectrum — chronic overactivity and chronic avoidance of activity — are associated with poorer outcomes, including more pain and more physical disability.(5) Sliding into doing almost nothing out of fear of the next flare carries its own costs, such as deconditioning, isolation, lower mood and often more pain over time, not less.
The goal isn’t to shrink your life down to whatever feels completely safe. The goal is something steadier in the middle.
What Pacing Actually Means
This middle path has a name: activity pacing. And it’s worth clearing up a common misunderstanding, because “pacing” is one of the most misused words in chronic illness.
Pacing is not doing less for the sake of doing less. Pacing is about distributing your activity more evenly over time, so you stay below the threshold that triggers a flare — and can therefore do more across the week, with fewer crashes.(6) It’s the difference between sprinting until you collapse and walking at a pace you can sustain all day.
A few principles make it work in real life.
Plan by the calendar, not by how you feel.
This is the hardest one. The temptation on a good day is to ride the wave as far as it goes. Pacing asks you to decide in advance roughly how much you’ll do and to stop when you hit that amount, even if you still feel fine. Especially if you still feel fine.
Break big tasks into smaller pieces.
Instead of deep-cleaning the whole kitchen in one burst, do one section, then genuinely rest before the next. The rest break isn’t a reward for finishing; it’s part of the work.
Build in recovery before you need it.
If you know a busy day is coming — a family event, travel, an appointment — plan lighter days on either side of it rather than scrambling to recover afterward.
Choose what to skip, not just what to do.
On a good day, ask not only “what can I finally get to?” but “what can wait?” Protecting your baseline is a legitimate use of a good day.
Pacing Is Nervous-System Care, Not Just Energy Management
It helps to remember why pacing works. Because the nervous system sensitizes in part through repeated overload, keeping activity steady is a way of keeping your nervous system below the level of activation that amplifies IC/BPS symptoms over time.(4) Pacing, in other words, isn’t only about managing energy — it’s about not constantly retriggering the alarm.
This is also why pacing pairs so well with the other tools that calm the nervous system: consistent sleep, gentle movement, breathwork and mind-body approaches. A randomized controlled trial found that an eight-week mindfulness-based stress reduction program led to significantly greater improvement in IC/BPS symptoms compared to usual care alone.(7) These approaches and steady pacing are working on the same underlying system.
A Note on Self-Compassion
There’s an emotional layer to the good-day trap that the research doesn’t fully capture, and it deserves to be named.
When you finally feel well, doing “normal person” things isn’t just practical, it’s deeply human. It’s a way of reclaiming a piece of the life IC/BPS keeps interrupting. So when pacing asks you to stop while you still feel good, it can feel like a loss. Like you’re giving up the one day you’d been waiting for.
Please be gentle with yourself here. Choosing to pace isn’t giving in to IC/BPS. It’s the opposite. It’s a strategic, informed decision to have more good days, more reliably, over the long haul instead of one good day followed by three bad ones. That’s not smaller living. That’s smarter living. (If guilt and frustration around your limits are weighing on you, our resources on the emotional side of IC/BPS may help.)
The Bottom Line
The good-day trap is so common because it comes from something good in you: the drive to live fully, to catch up, to make the most of feeling well. None of that is a character flaw.
But IC/BPS rewards a different kind of strength — the steadier, quieter discipline of doing a little less than you could on your best days so that you have more days that feel like your best. Pacing won’t make a good day feel as triumphant in the moment. What it can do is help the next morning feel a whole lot less like a punishment.
You’ve been protecting yourself the hard way for a long time. This is permission to start protecting yourself the sustainable way, and you don’t have to figure it out alone.
References
- Nielson WR, Jensen MP, Karsdorp PA, Vlaeyen JWS. Activity pacing in chronic pain: concepts, evidence, and future directions. Clin J Pain. 2013;29(5):461–468.
- Andrews NE, Strong J, Meredith PJ, et al. Overactivity in chronic pain: is it a valid construct? Pain. 2015;156(10):1991–2000.
- Lai HH, Vetter J, Song J, Andriole GL, Colditz GA, Sutcliffe S. Management of symptom flares and patient-reported flare triggers in interstitial cystitis/bladder pain syndrome (IC/BPS) — findings from one site of the MAPP Research Network. Urology. 2019;126:24–33.
- Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152(3 Suppl):S2–S15.
- Andrews NE, Strong J, Meredith PJ. Activity pacing, avoidance, endurance, and associations with patient functioning in chronic pain: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2012;93(11):2109–2121.
- Antcliff D, Keenan AM, Keeley P, Woby S, McGowan L. Testing a newly developed activity pacing framework for chronic pain/fatigue: a feasibility study. BMJ Open. 2021;11(12):e045398.
- Kanter G, Komesu YM, Qaedan F, et al. Mindfulness-based stress reduction as a novel treatment for interstitial cystitis/bladder pain syndrome: a randomized controlled trial. Int Urogynecol J. 2016;27(11):1705–1711.
