What is pacing?

Pacing is a valuable self-help skill for managing chronic pain. It enables you to plan and monitor your activities so that you are more in control of your everyday life and the pain.

Finding a helpful pacing style means:

•   Reaching a balanced pattern of varied activity at a steady pace, using time or distance not pain as a guide.

•   Doing some activity even at times when you don’t feel like it – for instance, when you are tired, in pain or feeling down.

•   Doing the same or similar levels of activity every day.

•   Not overdoing activities on better days.

•   Not under-doing activities on difficult days, despite pain, low mood or other problems.

•   Steadily increasing the amount you do and the types of activity over time.

To many people with chronic pain, it seems sensible to make plans and do activities based on the amount of pain experienced at the time. This can be helpful for acute pain after an injury. However, if it continues for more than a month or two, it may mean that the pain is in control of you and not the other way around! This is because your level of activity is set by the amount of pain (see Chapter 2 and Chapter 6).

In the long term, this way of pacing may mean that you achieve less, lose confidence, become tired more easily, lose physical fitness, become irritable or bad-tempered, lose contact with family, friends and work colleagues, have more pain, lack energy and drive, and lose motivation.

Pacing is an important skill to master, as it can help you:

•   Do more, over time, by yourself or with family and friends

•   Have more control over the pain

•   Have fewer setbacks

•   Help you use less medicines and have fewer side-effects

Learning to pace better takes practice, especially if you are new to the idea. It is just like learning to ride a bike, use a new cooker or do a watercolour painting. We all make mistakes at first. People with chronic pain who have learnt the skill of pacing have found it is well worth the time and effort. They report feeling better and more confident about themselves.

Let’s take Jim as an example. To help him pace better, Jim planned some time for relaxed breathing and did some stretches. He also planned his activities more carefully. He was delighted as he was able to do more around the garden and felt less tired. He asked his wife, Ann, to help him to pace better. She called him to collect a drink or a piece of fruit every 30 minutes to take to the garden. This meant he had a regular break from his task.

What are the different styles of pacing?

Generally there are two styles of pacing that are unhelpful for people with chronic pain, overactive and underactive. They both have advantages and disadvantages.

Look at the information below and decide which pacing style you currently use. It may be a mixture of both.

OVERACTIVE PACING

This means doing too much activity or too many tasks over a short space of time. This may happen if you are having a good day, with less pain, or your mood is better.

UNDERACTIVE PACING

This means that you are doing too little activity to help keep strength, stamina and flexibility in your muscles, ligaments, joints and bones. More of your time is spent resting, sitting or lying down. This is understandable, especially if there is a lot of pain. However, it may in itself add to your pain, as lack of fitness makes muscles and other tissues tight and weak. They then tire more easily when used or stretched (see Chapter 9), leading to more pain.