Daily Archives: August 10, 2012
After H-E-L-P, it seems there was some confusion by what I meant by ‘pacing’ so here is my explanation…
People with FM have chronic pain and cope with it in different ways:
• Some people stay active until they can do no more and then rest to recover before returning to an activity for as long as they can again. This may result in their pain getting worse or a ‘flare’ as they carry out an activity for too long. The time taken to rest tends to steadily increase.
• Some people manage very little and stop an activity at the slightest hint of pain in order to avoid over activity and ‘making things worse’. If such people begin to feel pain earlier and earlier in the activity this may stop them from participating at all.
• Some people decide that the good day/bad day cycle is too much of a roller coaster. They avoid doing much for fear of flaring-up pain. They don’t do much but at least they feel they are on top of the pain. But they have a poor quality of life, are not able to do much, have very little fun and often suffer from depression. They also feel a lot less fit and tired when trying to do anything. Often patterns of activity develop as people try to manage their pain. Life must go on, and day-to-day activities have to be done. People may say they have little choice and that they feel trapped or controlled by the pain.
Striking a balance between activity and rest is called PACING, so you don’t burn-out or become completely inactive. You need to take an active interest and involvement in the management of your pain; breaking the vicious circle of feeling worse and doing less.
The pain will still be there in the background. The theory behind pacing is quite simple: it is important that you spot the things that are making your pain worse and find ways to make this happen less often – this is part of pacing. Learning what to do when your pain is worse will also help, so that it does not add to the problem and end up making things worse.
How to Start Pacing
- Plan how you intend to start an activity and how long you will do it for. Just as an athlete in training you can then gradually build this up to a level which you are happy with. This pacing of your exercises helps you to introduce things in a controlled and responsible manner.
- Set yourself positive goals which are realistic, specific and measurable you will begin to see how you are progressing.
- Prioritise your activities so that you are achieving things in the order that you would like to. Also if you are finding things difficult then you can have finished the tasks most important to you.
- Exercise whenever possible, this will not only keep you fit and take your mind of things, but may also help you feel better.
Pacing & Spacing activities
Pacing is a technique that you can use to gradually increase your level of activity.
Pacing is all about breaking this pattern and gradually increasing what you can do. It should be possible to pace any activity, although in everyday life, we are not used to doing things gradually – we like to get things done quickly. But pacing really does work!
Start by choosing one or more activities that you want to be able to do, or be able to do for longer, e.g. walking, sitting, standing, etc. If it’s the first time you’ve tried pacing, don’t be too ambitious. Choose an activity that you find difficult, but not impossible. Set a baseline amount of time that you can easily and comfortably achieve. Then practice that activity regularly, every day if possible, on good days and bad. Then gradually build up the amount of time you spend doing this activity, but never do more than you planned. Write down your times on each occasion and this will help you to see how much you’re improving.
Pacing really does work; you can stay motivated by continually achieving a series of small goals!
Spacing involves breaking down an activity into manageable chunks and taking some time out between each chunk to rest and relax. By dividing up tasks in this way you can keep an eye on how you feel and how you are getting on with the task. Your rest periods might be a time for you to practice relaxation techniques, call a friend, listen to music, read the paper — whatever.
The idea of planning your activities and planning a rest break before your pain forces you to is a key technique of pacing and is called working to schedule.
Inactivity is harmful to your physical and mental health as well as to your chronic pain.
Pushing yourself to keep on at a task without taking a rest results in more pain and the need for increased recovery time.
Balancing your activity and rest is called pacing.
- Planning realistic activities each day.
- Planning several rest periods during the day.
- Resting before the pain gets worse.
Using a timer will remind you of your rest periods.
Organize your activities and avoid rushing.
The Flip Side
It all sounds easy, huh? This seems to be the hardest thing for most us to do – it’s really hard to say that you can’t see your nephew because you had physio and hydro and seeing him will take your activity schedule too far. What if there are two family events on one day? We know that’s going to be TOO much, so how do you pace this?
Pacing takes practice and experimentation, and more practice! Good luck!