Chronic pain can make it difficult to remain active. Many people with chronic pain do as much as they can on good days. This can cause an increase in pain, so that they need to reduce their activity for a few days. This is sometimes called a ‘boom and bust’ pattern. It can lead to reduced activity over time.
Pacing is a key skill in pain management. It involves taking a break before you need to so you have a consistent pattern of activity and rest. Over time, this is associated with being able to do more.
Often people tell us they are surprised how much they can get done by sticking to this approach.
How to try pacing
If you would like to try pacing you can follow these steps:
1. Decide on an activity you would like to pace
This might be exercise or physical activity. It might also be something you used to do for fun and have not done for a while. People we have worked with have used pacing for all kinds of activities – from sitting at the table to eat with their family, to walking their local parkrun!
2. Set a SMART goal for this activity
SMART goals are:
3. Set your baseline
- Specific – they describe exactly what actions you should take (for example I will go for a 15 minute walk every Sunday)
- Meaningful –they add quality to your life and fit with what means most to you
- Adaptive – are designed to increase your quality of life in some way. They might improve your physical or emotional health or your relationships.
- Realistic – avoid targets that are too ambitious. Success breeds success. Setting smaller achievable goals is the best approach.
- Time framed – say clearly when you will achieve it by.
Decide how much you can do without flaring up your pain. If you are not sure what you can do keep a record of the activity over several days. Write down what you did and note how you were afterwards. Use your records to decide what you are able to do consistently.
4. Make a plan for what you will do
The best plans include what you will do, when you will do it and for how long. For example, you might decide you are going to walk the dog for 10 minutes every morning. If you can’t do it all in one go, break it down into smaller steps and
5. Stick to the plan
It can be tempting to do more on a good day or to avoid activity on a bad day. Sticking to the plan is an important part of pacing. Some people find using a timer or reminder to stop helpful. If you have changes to your health or a significant flare up to your pain that prevents you sticking to the plan don’t give up. Follow advice you have been given about flare-ups or changes in your condition and return to pacing as soon as you are able.
6. Review your progress
When you are able to stick with your plan easily and consistently it is time to think about the next step. You can follow these steps again to set a new baseline, or introduce another paced activity into your routine.
Pacing is a tried and tested technique. People who use it often tell us they can do more than they expected and feel better about themselves as a result.
Pacing can be tricky to stick to. It can be frustrating to take a break in the middle of a task. Some people find it tricky to plan activities in advance. If you try pacing but fall back into old activity patterns don’t worry – this is a normal part of learning a new skill. You can simply start again.
Often people tell us that pacing took a few goes to get right but they are glad they stuck with it. Once people are using pacing well they find they get more done and manage their pain better.