Pacing and Chronic Pain

If you have had chronic pain for a while you will no doubt have lost some physical fitness . A really important part of managing chronic lower back pain is to increase activity levels.

However, like most people with chronic lower back pain you are probably less active than you used to be. You may have noticed yourself in a cycle of ‘boom and bust’ with activities and exercise.

A good example of this is someone who has pain that interferes with normal day to day activities. This person may wakes up one day and feel they are having a ‘good day’ and so decide to mow the lawn, and go for a walk while it’s good. The next day symptoms are worse and so they feel they overdid it and decide to take it really easy for a few days. Eventually it settles and the pattern is rep14-Sep-2009 everything all at once because they know its going to be sore and they just want to get it all over with and suffer the consequences.

The important thing with both these ways of approaching activity is they are not helping with improving fitness levels at all really. The activity is followed by inactivity – ‘boom and bust’. Their baseline level of fitness never really improves – if anything it gets worse. The cycle of chronic pain continues.

In order to overcome this it is important to use pacing skills to determine how much activity is the right amount for you to start with – it may be a very small amount initially. The key thing though is that you can build on small amounts – if you take it steady you can do some more the next day. Each small step leads you in the right direction – upwards towards greater physical fitness and a better quality of life.

pacing

You need to start by establishing a baseline – let’s say for example you want to increase the amount of walking you do. Think about how far you can walk now without a flare up? Is it five minutes? If so that is fine – you begin with walking just a few minutes and aim to build up very slightly week by week. Keep a record of how much you can do and plan to gradually increase it over many weeks.

Pacing takes patience though, you have to be very calm and kind to yourself throughout.

Set your self some goals – say for example being able to walk to the local shop (10 minutes walk) in a month. Plan your progression to aim for this and remember that you have plenty of time to reach your goals.

Chronic pain is complex - expect the odd setback. Its rare that someone follows a perfect line like the picture above, usually there are peaks and troughs but as long as the overall movement is upwards then that's fine.
Eventually you will find that you can achieve a lot more in your daily life.

If you are struggling a lot with chronic pain and pacing and feel you cannot exercise because of it you should seek specialist support from a chronic pain management programme that will help you pace and improve your daily activity levels.