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Friday, 20 October 2017
This page aims to answer some of the questions you may have about the Chronic Pain Management Service and coping with your pain. If cannot find the answer you need, you can contact us on 01473 703435 and we will do our best to answer your query.

Chronic Pain Management Service FAQs

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I've been told I need to pace my activities. What does this actually mean? Am I doing it right?

What professionals mean when they talk about 'pacing' is often quite different from what the rest of us think of as pacing. The idea of pacing is to do everyday tasks and activities in a way which does not make your pain any worse.

Often people find themselves in a cycle where during a ‘good period’ (where the pain is more bearable) they push themselves to achieve a lot. This leaves them in more pain and exhausted, which leads to a ‘bad period’ where they have to rest and achieve very little, which makes them frustrated. As soon as they have a ‘good period’ they try to make up for feeling like this by doing too much, and as a result they have another ‘bad period’… And so the cycle continues!

Pacing is a way of breaking this cycle. The aim is to do daily activities in a way which keeps the pain at a bearable level and avoids worsening of pain. The idea is to avoid ‘overdoing’ things (doing too much) and causing the pain to worsen.

In practice, this means breaking up periods of activity into manageable chunks, and swapping your activity or changing position regularly (not resting), to avoid overdoing any one activity and causing an increase in pain. 

Imagine that a worsening in your pain is like an alarm going off, telling you that you have been in one position or doing an activity for too long. The aim of pacing is to do things in a way which avoids triggering the alarm to go off. If you are stopping an activity when your pain increases, you are leaving it too late – the alarm has already gone off

In the long run, pacing can help you manage your pain much more effectively, by keeping it at a lower level, avoiding flare-ups and ‘bad periods’, and enabling you to achieve more.

Here is an example:

Photo depicting gardening

On a good day when her pain was less, Ranjit would try to get in the garden and happily spend hours digging, planting, raking, pruning, weeding and mowing. The next day she would wake up in agony and would have to spend the day resting on the sofa. This would make her frustrated and upset, especially as she would think over all the things she could be achieving in that time, which would make her feel guilty. After having rested, she would feel in less pain again, and would get back in the garden.

Ranjit decided to try some pacing strategies. She worked out that she could spend 15 minutes on a light gardening task and 10 minutes on a heavier task without making the pain worse. She used a timer to pace herself, and when it sounded would make sure to swap activities and positions: she would go to make a drink, put in some stretches, change her position, wander round and admire the garden, sit on the bench for a few minutes, or would change from a heavier activity to a lighter one (for example, going from standing to mow the lawn to sitting on a stool to pot seedlings). Once she had done this, she would return to her original task for 10 or 15 minutes, at which point she would change position / activity again.

She soon found that she had far fewer ‘bad days’, that her pain levels were more consistent and bearable, and that over time (because of fewer rest days needed) she achieved more in the garden than before she paced.

The key to pacing is establishing your tolerances: the period of time you can be in one position or do one activity without making your pain worse. If you are doing something until your pain worsens, then you have already exceeded your tolerance.

Once you reach your tolerance - before the pain worsens - you change activity or position (if you are in a situation in which it is not possible to change activity, then a change in posture or putting in some simple stretches can be enough). You can then swap back to the original activity or position, and do it until you reach your tolerance. You would then change position or activity again, and so on...

Although using pacing can seem like a big commitment, most people find that it really is worth their while. They usually find an overall reduction in their pain, because it is not constantly being triggered into worsening.

Although people sometimes fear they will achieve less because they regularly have to change activity or position, in actual fact most people find they do more in the long run because they have fewer ‘bad periods’ are able to do things more steadily and consistently, and have less need to rest. Over time, pacing becomes a habit like any other – it becomes much more automatic and requires much less thought and effort.

Because most people find they are able to do things more steadily with pacing and need fewer rest days, they often find their tolerances for the length of time they can do activities gradually building up, and find themselves feeling better about what they are able to achieve, and more in control of their pain.