Mandy had changed her car. Not for a new one, for a higher one, because getting in and out of the old one had become the worst part of her day. She was also seriously looking at moving house, because the stairs had started to feel like a daily obstacle rather than a staircase.
Every one of those decisions was reasonable in isolation. That is what makes this pattern so difficult to spot from the inside. Each adjustment solves an immediate problem, and each one quietly reduces what your body is asked to do.
The trouble is that capacity follows demand. Take away the stairs and the getting in and out and the reaching, and within a few months the tissues that used to handle it comfortably no longer can. Which makes everything hurt more, which prompts the next adjustment.
By the time we saw her, avoidance had become the larger problem. Her back was not more damaged than it had been two years earlier. It was significantly less capable, and she had lost most of her confidence in it.
The plan was not about pushing through pain, which would have failed immediately and confirmed everything she feared. It was about rebuilding tolerance in increments small enough that her confidence could keep pace with her body.
Stairs came back before the car did. Both came back. The house move stopped being about the stairs and went back to being a decision she could make for ordinary reasons.
If pain is quietly making your decisions for you, that is worth addressing properly rather than accommodating indefinitely.