"Pace Yourself"; a couple of words that are often used as 'advice' for people in pain, however often not accompanied by any real explanation as to what it actually means. Often there is the assumption that when one says that you should 'pace yourself', the recipient of this advice will automatically know what this means, and maybe just do a bit less, however there's more to it than that and spending a bit of time planning can go a long way.
Ok, so how do you go about pacing to manage your pain better? Firstly it's important that you don't stop doing everything. This can actually have a detrimental effect. By stopping everything you normally do, you may end up losing muscle, thus losing your support (or scaffolding) of your joints, and actually end up in more pain than you started out with. The key thing is to work out your baseline activity tolerance i.e. the amount of activity you can tolerate with some mild discomfort, but that resolves within 30 minutes of completing the activity e.g. walking for 15 minutes to the shop and back, vacuuming two rooms, or taking the dog for a walk around the park. If you end up with high pain, and discomfort that lasts for hours and is also causing you more pain than usual the next day, you have likely done too much and you've exceeded your baseline.
You need to keep your normal exercise and activity going as much as possible, or even introduce new activities or exercises, but take a step back and think about it first. It's then time to plan. There are many ways that you can do this, but one way I like to do this is by using the traffic light system and it's quite visual. If you like, you could even get yourself some post-it notes to write on all of the different activities you do. So, let's take a look how this works.
Traffic Light System
Red = most difficult activities, Amber = moderate activities, Green = easiest activities.
Split your activities for the week in to the three different colours; Red, Amber and Green. E.g. Vacuuming, a supermarket shop or looking after the grandchildren may be red; walking to the park or cooking a big meal for friends may be amber; and having breakfast or putting the laundry on may be green. Remember, it's different for every person, everyone's list will be unique to them so using a pre-made list or what your friend thinks is of no use.
Plan your week so that you spread out the activities evenly over the week. You should have a mix of different colours. It is especially important that you do not have too many red's or amber's together.
If an activity is lengthy and red or amber (e.g. vacuuming the house), then split it up in to smaller chunks, even over multiple days. For example do downstairs one day and upstairs the next, or break it down even further if needed.
Take breaks and allow yourself to rest without beating yourself up. Just don't sit for too long without any movement; change postures regularly to stay comfortable and keep the joints moving.
Ask for support from your family and friends. Let them know what you're trying to do so they understand and don't pressurise you to constantly overdo things.
Remember, it can take a bit of getting used to but it can really improve quality of life in the long term. It's not admitting defeat, it's working with your pain instead of against it, and this can pay dividends.
The other place where people commonly go wrong (but is a completely natural thing to do), is to do far too much on 'good' days and then really suffer for a day or two (or more) later. What happens then is that you do very little, if anything, on the 'bad' days and over time this 'Boom-Bust' habit actually results in loss of muscle strength, loss of function and increased pain. Not where you want to be! Again, this is where the traffic light system can really help, and making sure you stick to it.
Flare-Ups
Remember, flare-ups are unfortunately part of the parcel however which- way you go about things, although they may be more manageable if you've been pacing yourself well. They will happen from time to time and it's important you manage them. Don't panic, but temporarily reduce your activity a little more while things settle. Do you have some pain medications that you know you can safely take for a few days? If not, have a discussion with a Pharmacist, or your GP/MD.
Maybe try to use regular heat or cold (whichever suits you best) to help manage the pain if you don't have any skin issues in the area, any circulation problems or sensation loss. Just remember to always cover the hot/cold pack and check the skin regularly, and only use cold for about 10-15 minutes every two hours (more about this in an up-coming article).
If you're going through a stressful time, try to find ways to relax and switch off, even if it's just for 10 minutes a day. If you're not sleeping well, try to find ways to sleep better, use pillows to make yourself more comfortable, read a book before bed or have a bath, and avoid caffiene after 12pm. Plus remember, don't eat too late as this may also affect your ability to sleep.
Pacing really can help and it's under your control. Be persistent and give it time. Keep a record of what you are managing on a daily basis and over time you should start to find that your baseline actually improves, and you can manage more without those increased levels of pain.
So go on, give it a go, stick with it and look after yourself.
Please remember, there's different types of pacing required for different people. I have primarily been talking about what I usually discuss with my physiotherapy patients with osteoarthritis and then we test and adjust as needed. If, however, you are suffering with chronic fatigue syndrome, fibromyalgia, ME, post-viral fatigue (e.g. recovering from Covid-19), this can be a whole different kettle of fish. Rheumatology clinics are well placed for helping with this type of fatigue and pacing, and where I'd recommend you look for further advice, although the advice which I mention above may help some in these situations, but consult your GP /MD or rheumatologist first.
Please note: This article is intended to be for educational purposes only, and does not constitute medical advice or replace professional assessment or personalised advice.
I do not hold responsibility for the information on any links to external websites within this article and information within these links/websites may change at any time or no longer be accessible. Any website pages/links added are also for education purposes only.
#physiotherapy #holisticphysiotherapy #healthcoaching #painmanagement #osteoarthritis #osteoarthritismanagement #pacing
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