Chronic pain can change the way that people live their lives and carry out their daily activities. For example, many people found that they could no longer perform certain tasks without experiencing increased pain and fatigue. This could lead to them becoming increasingly inactive, or catching up on jobs when they had a good day, which then lead to a flare-up of pain and the need to rest up for a few days (see also ‘Coping with flare-up’).
Many of the people that we talked to had learnt techniques to manage their activities, minimise their pain and help prevent flare-ups. Usually these techniques had been learnt on NHS pain management programmes through healthcare professionals, or support groups, but others had learnt through the internet or books (see also ‘Learning about pain management‘; ‘NHS pain management programmes‘).
People learned to pace their jobs by breaking them down into smaller more manageable tasks. Many found it was important to learn their limitations. One man explained that it is useful to work out the length of time that you can do something before it gets painful and then take 20% off this time so that you stop before the pain ‘kicks in’. This is called ‘setting a baseline’.
Explains how to work out a baseline of how long you can do something for before the pain increases.
Some found it helpful to leave post-it notes around the house, or set a timer to remind them to stop. Stopping to have a rest, do another activity, stretch or change position could all help. The length of time that they could do each activity was not set and could be gradually increased. However, during a flare-up of pain it was sometimes necessary to reduce the time and gradually build it up again as pain subsided.
Paces herself by prioritising when she is going to walk and when she is sitting uses a buzzer to…
Has learnt to gradually increase the length of time that she can walk the dog.
Pacing could be applied to all activities from preparing a meal to decorating a room, building or office work. Some found that a job that they used to do in a day had to be spread over a number of days or weeks but found satisfaction in being able to complete a job without increasing their pain.
One man gave the example of cutting his grass over two or more days. However, he would save jobs which needed to be done in one go for a ‘good day’.
Finds he can achieve jobs by doing them over a few days but saves jobs that need to be done in…
Prioritising the jobs that really needed to be done was an important part of pacing. A few people had learned to recognise feelings that they pushed themselves over the limit by telling themselves that they ‘ought to’ or ‘should do’ a job and realised that it was not the end of the world if something did not get done.
Feels it is important to prioritise important jobs and accept that it is not the end of the world…
A woman who had always prided herself on completing all of her housework by mid-morning recognised that it was okay to lower her standards. Most recognised that it was better to pace an activity than end up with increased pain.
Feels he is not a natural pacer but knows that it is better to pace than end up in pain.
Pacing did not come naturally to some people, who feel frustrated not to be able to complete tasks as they used to. Others felt that it was important to push the boundaries and occasionally overdid things. Although this could result in a flare-up of pain, they decided it was worth it for something specific and sometimes planned time to deal with the flare-up.
Setting short and long-term goals is important for many people. One man explained that he set himself small daily goals, for example walking round the garden or meeting his wife from work. Several people had set themselves goals, which required them to be more active and that they had had to gradually work up to.
Feels it is important for him set and achieve small goals each day.
These ranged from aiming to sit in a normal chair, to getting back on a bicycle, or even climbing a small mountain. Another person described increasing her exercise to achieve her goal of going on safari.
While he was at the pain management programme he set, worked towards and achieved his goal of…
Worked on increasing her fitness so she could achieve her goal of going on a camping safari holiday.
A man explained that an important part of achieving a goal was problem solving and asking others how they did things.