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Managing good days and bad days

Research regarding people who have persistent pain suggests that the greatest long-term benefits are felt by those who keep practising relaxation, pacing and a gentle fitness programme, but when you have persistent pain, managing these and ‘everyday’ activities can be very difficult. It might feel like the pain is in control. There can be traps to fall into; pushing through pain, avoiding activity, or falling into a ‘boom and bust’ cycle.  

What is Pacing?

Pacing is a helpful technique and the word we use to describe how to best manage your activities.

Pacing helps by balancing the day, making simple changes in posture and/or creating rests in between activities. It is about being aware of particular activities or the periods of time that reduce or increase your pain.

Pacing helps avoid "overdoing it", both physically and emotionally. It will help you manage the day better and, by keeping to your planned target, means that you will be more in control of how much you do. The aim is to maintain an even level of activity over the day and week and may help to increase levels of activity or productivity overall.

Ask for help if you need to and learn to accept help that is given.

The 3 P’s … Prioritising, Planning and Pacing.

Prioritising

What has got to be done today or this week and what could wait until tomorrow/next week or be delegated to someone else?

Planning

Once you have prioritised what has got to be done, it may help to make a plan. To begin with, do one important activity on each day at most.  Make sure you plan to take regular breaks and be realistic - don’t set your targets too high.

Pacing

Be aware of signs that you may be overdoing it. It is a good idea to change posture regularly. Try to do the same level of activity every day to avoid getting into the ‘boom and bust’ cycle. Think ‘Little and Often’.  Remember to change position regularly. Vary your activities between standing, sitting and walking and take rest breaks. Be aware of sensations, such as fatigue or tension, that may be an indication that you need to adjust your level of activity.

 ‘‘Be kind to yourself, change takes time.’’

How do I know when my approach is working?

You will know your approach is working when:

  • Your activity levels become more stable and may start to increase
  • Your confidence to do activities begins to improve
  • You find yourself doing activities that you haven’t been able to do for quite a while
  • You feel confident to try out new activities

Sometimes it doesn’t work, and that’s okay! We can learn from why something did not go to plan, and make changes for the next time.

Equipment

Ask yourself if you could change the equipment you are using to make it easier. Consider using long handled tools, or smaller, light weight models of lawn mowers and vacuum cleaners.

Make use of labour-saving devices such as food processors and slow cookers.

Your occupational therapist should be able to review and/or advise on further individual equipment needs.

Pain Management Programme

We recognise how much people living with pain want to live well and continue with the activities that matter to them most, so our pain management programme works greatly on pacing and will help you to develop tailored approaches to managing daily activities.  To see how to access the pain self-management services and Pain Management Programme please see the ‘Referrals’ section by clicking the link to the right of the page.

For more information, helpful tips and experiences shared by other people dealing with chronic health conditions and/or persistent pain, click this link for the Health Talk website.

An excellent video by Dr Mike Evans on the benefits of exercise on health and well-being can be accessed via this link.

For further information on improving your fitness and pacing, the Australian Pain Management Association offers some guidance here, but always seek tailored advice from your health professionals such as GP or physiotherapist when making significant changes to your health and exercise regimes.

© Wye valley NHS Trust 2019