Thanksgiving with Chronic Pain: How to Show Up Without Overdoing It
Thanksgiving is coming, and you're already worried about it.
You want to be with family. You want to enjoy the meal and the conversation and the traditions. But you know what happens when you try to do "normal" things while managing chronic pain.
You'll overdo it. You'll push through cooking or traveling or sitting at the table too long. You'll pretend you're fine because you don't want to be the person who ruins Thanksgiving. And then you'll pay for it for days afterward—maybe weeks.
Here's what we want you to know: You don't have to choose between showing up for Thanksgiving and taking care of your body. There's a way to be present for what matters while respecting your limits. It's not always easy, but it's possible.
At Aspire Counseling, we work with people dealing with chronic pain throughout Missouri. Holidays are often one of the hardest times—not because of the pain itself, but because of the pressure to act like you're fine when you're not.
Here's how to approach Thanksgiving differently this year.
Why Do Holidays Make Chronic Pain Worse?
If your pain seems to flare around holidays, you're not imagining it. There are real reasons holidays are harder on your body.
You push yourself harder. On a normal Tuesday, you might pace yourself and rest when needed. But on Thanksgiving? You try to do everything—cook, host, travel, socialize—because it's "special." Your body doesn't know it's a holiday. It just knows you're asking it to do more than usual.
Stress increases. Even good stress activates your nervous system. Family dynamics, cooking logistics, travel plans, pressure to have a perfect day—all of this keeps your nervous system on high alert. And when your nervous system is activated, pain gets worse.
You sit in uncomfortable positions. Maybe the dining room chairs aren't great for your back. Or you're standing in the kitchen longer than usual. Small discomforts add up when you can't take breaks.
Sleep and routine get disrupted. If you're traveling, you're not in your own bed. If you're hosting, you're staying up late preparing. Changes to sleep patterns lower your pain threshold and make everything hurt more.
You feel guilty about limitations. When you need to rest or say no to activities, there's often guilt. That guilt creates tension, which creates more pain. The emotional component of chronic pain during holidays is significant.
Understanding why holidays are harder helps you plan differently. You're not weak or broken. You're dealing with real factors that affect pain—and you can work with them.
How Do I Set Boundaries About What I Can Do?
This is often the hardest part. You don't want to disappoint people. You don't want to be the "difficult" one who has special needs. You don't want to explain your pain again.
But here's the truth: Boundaries protect both you and the people you love. When you push past your limits, you end up in a terrible flare—and then you're completely unavailable for days afterward. Boundaries mean you can actually be present.
Here's how to set boundaries around Thanksgiving:
Decide your priorities ahead of time. You probably can't do everything. What matters most? Being there for the meal? Helping with one specific dish? Having conversation time with certain people? Choose what's most important and let go of the rest.
Communicate your needs before you arrive. Don't wait until you're in pain to say something. Before Thanksgiving, let your host know: "I'm really looking forward to this, and I need to manage my pain. I might need to take breaks or leave earlier than others. That's about my body, not about how much I want to be there."
Give people specific ways to support you. Instead of "let me know if you need anything" (which puts the burden on you), try: "I need a comfortable place to sit during dinner" or "I'll need to lie down for 20 minutes in the afternoon—is there a quiet room I could use?"
It's okay to modify traditions. If standing in the kitchen for hours making pie was always your thing but now it causes a flare, it's okay to bring a store-bought pie. The tradition can evolve. You're not failing by adapting.
Remember: People who love you want you to be okay. They'd rather you take care of yourself than push until you're miserable. If someone gives you a hard time about boundaries, that's information about them, not evidence that you're doing something wrong.
We have a great post on validating yourself and acknowledging your emotions that can help when you're feeling guilty about setting limits.
What If I Feel Guilty About Not Doing Enough?
Guilt is one of the most common emotions people with chronic pain experience around holidays. You feel like you're letting people down. You feel like you should be able to do more. You compare yourself to who you were before pain, or to other people who don't have limitations.
That guilt is understandable. And it's also not helping you.
Here's what to remember:
You're doing the best you can with the body you have right now. That's enough. You don't owe anyone an explanation for your limitations.
Pain doesn't make you less valuable. Your worth isn't measured by how much you can cook or clean or entertain. You matter because you're you—not because of what you can do.
Setting limits is responsible, not selfish. When you take care of yourself, you're actually more present for the people you love. When you push past your limits, you end up resentful, in pain, and unavailable.
Other people's disappointment is not your responsibility. If someone is upset that you can't host this year or can't stay as long as they'd like, that's their feeling to work through. You can care about their disappointment without making it mean you did something wrong.
The people who matter will understand. And if they don't? That's hard, but it's still not a reason to hurt yourself trying to meet impossible expectations.
This time of year, there's a lot of pressure to be grateful for everything. But sometimes, gratitude feels impossible when you're in pain. That's okay too. Our post on a tradition of gratitude explores how to think about thankfulness in a way that doesn't require you to pretend everything is fine.
How Do I Actually Pace Myself on Thanksgiving Day?
Pacing is one of the most important skills for managing chronic pain during holidays. It means doing less than you think you can, taking breaks before you need them, and spreading activities out over time.
Here's what pacing looks like on Thanksgiving:
Plan rest periods into your day. Don't wait until you're in pain to rest. Schedule breaks: "After we eat, I'm going to lie down for 30 minutes." Treat these as non-negotiable appointments.
Do 70% of what you think you can manage. If you think you can help cook for two hours, plan for 90 minutes. If you think you can stay until 8pm, plan to leave by 7pm. This buffer prevents you from overdoing it.
Ask for help with physical tasks. Let someone else carry the heavy dishes. Let someone else stand at the stove stirring. Let someone else clean up. Accepting help isn't weakness—it's wisdom.
Pay attention to early warning signs. Don't wait until you're in a full flare to do something. Notice when tension is building in your shoulders, or when you're starting to feel fatigued, or when pain is creeping up. That's your signal to take a break.
Be willing to leave early or skip parts of the day. If you need to arrive late or leave before dessert, that's okay. Being there for part of Thanksgiving is better than pushing through the whole day and ending up in bed for a week.
Remember: Slow is fast. When you pace yourself, you can actually participate more over time. When you push too hard, you end up completely sidelined.
What Are Practical Ways to Reduce Physical Strain?
Beyond pacing, there are specific things you can do to reduce the physical demands of Thanksgiving:
If you're traveling: Break up the drive with frequent stops. Bring a pillow for your back. Consider driving on Wednesday instead of Thursday to give yourself a day to recover before the meal.
If you're cooking: Sit while you prep food. Use tools that make tasks easier (electric can opener, food processor). Spread cooking over several days instead of doing everything Thursday morning. Or honestly? It's okay to not cook. Bring something simple or store-bought.
If you're hosting: Ask people to bring dishes so you're not responsible for everything. Set up the dining room so you have a comfortable chair. Consider a buffet-style meal so you don't have to keep getting up to pass dishes.
If you're eating at someone else's house: Bring a cushion if their chairs are uncomfortable. Don't feel obligated to help clean up if standing at the sink will cause a flare. It's okay to excuse yourself to lie down if you need to.
Consider alternatives to traditional gatherings. What if you did a smaller Thanksgiving at home? Or had a Friendsgiving on a different day when you're feeling better? There's no rule that says you have to celebrate on the exact day or in the exact way everyone else does.
When Is It Okay to Skip Thanksgiving Entirely?
Sometimes the most self-compassionate choice is not to go at all.
It's okay to skip Thanksgiving if:
You're in a severe flare and traveling or hosting would make it significantly worse
The family dynamics are toxic or stressful in ways that aren't worth the physical toll
You genuinely need rest more than you need to be at a gathering
The expectations or pressure feel impossible to navigate
Skipping doesn't make you a bad person. It makes you someone who's taking their health seriously.
If you do skip, you can still mark the day in a way that feels meaningful to you—order takeout you enjoy, watch movies, rest, connect with a friend over the phone. Thanksgiving doesn't have to look traditional to count.
And if people are upset about it? That's hard. But you're not responsible for managing their feelings at the expense of your wellbeing.
You Don't Have to Choose Between Pain and People
The pressure to push through pain during holidays is real. But you also don't have to sacrifice your body to prove you care about people.
The people who love you want you present—not perfect. They want you there in whatever way you can manage. And if they don't? Then the problem isn't your pain or your limitations. The problem is their expectations.
Chronic pain during holidays is hard enough without adding guilt and shame. You're allowed to need what you need. You're allowed to set boundaries. You're allowed to show up differently than you used to.
If you're struggling with chronic pain—during holidays or any other time—we can help. We work with people throughout Missouri dealing with fibromyalgia, back pain, migraines, autoimmune conditions, and many other types of chronic pain. Learn more about our approach to chronic pain therapy.
Schedule your free consultation by contacting us online or calling 573-328-2288.
Wishing you a Thanksgiving where you can be present for what matters—without paying for it with days of increased pain.
This article was written by the clinical team at Aspire Counseling, a therapy practice in Lee's Summit and Columbia, Missouri, specializing in chronic pain, anxiety, and trauma. We use evidence-based approaches including Internal Family Systems (IFS), Pain Reprocessing Therapy (PRT), and Mindfulness Oriented Recovery Enhancement (MORE) to help clients with chronic pain. Available in person in Lee's Summit and online throughout Missouri.
