Suffering from Chronic Pain

Pacing is a skill you can use to manage your activities by London Pain Clinic, but it can mean different things in different situations.

When restrictive, pacing can feel frustrating and limiting, especially when it prevents you from doing activities you value.

However, when used in a flexible way, it’s an important skill that can help you to start and sustain activities that matter to you.

You may believe that pacing means you need to stop doing most of the things you love and spend a lot of time doing nothing.

However, this is not the case.

People often take a “trial and error” approach, in order to do more of what is important to them. Don’t be too rigid with yourself or your activities.

Here are some different approaches that you may want to experiment with to see if they work for you:

Breaking up activities

If doing too much of a particular activity increases your Lower Back Pain Right Side symptoms, you may want to think about how you can adapt to the task and when you do it.

You may find you're able to complete an activity if you break it up with rest breaks in between.   

Some people prefer to separate a larger task into a number of smaller tasks, and then spread out these tasks over a period of time.

Physical activities, mental tasks, emotional activities and rest can all be tiring if done for a period of time. Yes, even resting!

A break may just be alternating different types of activities, as they are tiring in different ways.  

For example:

• Work out a route for a walk that allows you to sit on a bench for a few minutes to bring symptoms to a steady level.

• If you're struggling to concentrate, then switch between mental tasks and something physical (like a small stretch). Continuing could lead to more mistakes and more work correcting them in the long run.

• Spread activities over several hours or days, e.g. do one room per day if cleaning, rather than dusting or vacuuming your whole home.

• Set a timer for a particular task and only do that activity, with no distractions, until the alarm goes off.

Breaks don’t need to belong, even less than a minute can be a refresh if you haven’t pushed too far.   

Some people find that stopping before pain and other symptoms make them stop is helpful.

To do this, it’s important to become aware of what your own personal clues are, that you are starting to push yourself.

Holding your breath, tense muscles, getting hot, feelings of frustration can all be the passengers that are shouting at you to push through.

Some people find it more difficult to break up their activities when they are under time pressure, with others, busy or having a good day.

Pushing activity will be worth it in some situations and not in others.

Recognising this can be helpful for the future, as you may need to remind yourself to stop, and perhaps take more rest breaks on your busier days.

If you are breaking up activities, you may discover your bad days are not as difficult and you can start building capacity to do what matters.

The aim is to be able to repeat that activity again in the future, without worry or fear about the consequences.

Pacing is an approach to doing activities alongside your symptoms.

Consistent daily activities

This is where you do roughly the same amount of activities most days, so you maintain a level of fitness, mobility, strength and balance.

This may not be possible for everyone, depending on your own personal experience of pain and fatigue, especially at the beginning.

However, as always, even the smallest move towards a different way of doing things can really add up over time.

This is where introducing routines can be helpful.

For example, think about getting out of bed and getting dressed. It’s not a big exercise routine, but it can involve challenging movements and can be draining.

Getting dressed every day may seem like an unnecessary effort for many people living with pain.  

This is a particular problem if they’re not going out that day or expecting anyone to visit. However, if not getting dressed becomes a habit, it can become harder to do in the long run.

It then means that on the days they do need to go out, they may already be fatigued and sore by the time they close the front door because they’re already doing more activity than they’re used to.

Wearing different clothes during the day and at night can maintain our movement and help our sleep by signalling a change from day to night.

Our day clothes do not need to be formal. Even a change from night clothes to comfy clothes (or a day pyjama top) can make a difference. Be as comfortable as you need to be!

Having a daily routine can reduce some of the decision fatigue and can keep you moving towards your goals and the life you want to live.

 Here are some examples of routines that some people have found beneficial:

• Get dressed daily - perhaps changing your nightclothes and brushing your teeth on your worst days.

• Moving your body - this may be a specific walk or class on better days. On your worst days you may do gentle movements before getting out of bed to go to the toilet. This can act as a “warm-up” to ease stiff joints and increase circulation.

• Doing one small task, even on your worst days. This may just be wiping the table or making your bed.

Leva Clinic

Leva Clinic is the UK’s first fully registered online clinic for chronic pain management. Leva provide a personalised care package with a dedicated pain team including doctors, nurses, physiotherapists and clinical psychologists. Leva clinic is currently offering a free assessment call. For more information, go to www.levaclinic.com