Pacing with Chronic Pain

We know what pacing means in the context of running or exercise or “pacing oneself” with other activities such as drinking or working. When it comes to chronic pain, pacing is a skill that helps a person with pain to manage productivity and also increase ability to tolerate activity. Individuals with chronic pain tend to have some level of ebb and flow with their pain, some days are worse, and other days are better. On the days that are good, the individual tends to overcompensate with accomplishing tasks and engaging in activity they are not able to on bad days. What happens is, they exhaust themselves and then tend to experience a drop in energy and increase in pain the following day/days.

Pacing can be challenging but is a useful way to try to manage the ups and downs. This comes down to organization and planning.

How to Activity Pace:

Step 1: Determine what your most important activities are (playing with your kids, household tasks, walking the dog).

Step 2: Creating a schedule with these activities in it for small bits of time, break it up into parts which will help you to move around and engage in our next step.

Step 3: Planned breaks in activity. Especially after periods of activity, build in periods of relaxation, stretching, light walking prior to returning to activity.

  • This cycle of activity and relaxation will be repeated daily.
  • When you feel good, do not do more than the schedule allows, and on a bad day, try to keep up with your goals.
  • Avoid remaining in one position for more than 30 minutes.
  • Slowly increase activity as tolerated

I have attached an example of a worksheet you can use to plan pacing until it becomes a habit and second nature for you.

Lies We Tell Ourselves: Cognitive Distortions

It took me until age today to realize how much time I spent talking myself into believing all of the things that I was bad at or couldn’t do. Somewhere along the way, I built up a system of lies that I told myself and others. “I am bad at math” (okay, that one is true). “I am not creative.” “I am not a tech person.” “I don’t have an entrepreneurial bone in my body.” Now this all plays into my self-deprecating sense of humor those that know me have come to love. However, I blindly subscribed to beliefs that have no basis in reality, except the math thing. How many adventures did this stop me from going on? What did these deeply rooted false beliefs prevent me from learning or growing from?

This realization could have caused me to spiral into all of the what ifs, but I am choosing to use it to reframe my future. My main therapeutic framework is Cognitive Behavioral Therapy which means I help people identify automatic negative thoughts that then lead to unwanted feelings and unwanted behavior. I am attempting to apply that process to this system of thoughts I developed probably very early on.

These new realizations came from a decision to build a private counseling practice. All of a sudden, I was filled with creative ideas, entrepreneurial ideas for how to use my skills to help people in a way that fits me. I designed my website and even used some basic coding skills. I got positive feedback about the site, some even asked if I might help with theirs. The thought “I am not a tech person” pops in. Look at all the evidence to the contrary. It appears, I am actually quite good at it.

 “I am not creative.” No, I do not knit, paint or draw worth a crap. That does not mean that I am not creative in other ways. I can sing, build websites, have a lot of entrepreneurial ideas and other traits that do not fit the prescribed personality and profile I created for myself over the years.

Consider what lies you tell yourself about your abilities and things you think you are bad at or cannot do. We all have weaknesses (math), and that’s okay, but there are likely a number of things that you can do and are good at that you are unaware of. Become aware of the thought, recognize it, stop it in its tracks, question it, admit that it is untrue/irrational and then replace it with the truth.