Pacing and Chronic Pain

Pacing and Chronic Pain


Chronic pain is typically defined as a pain that lasts for more than six months, inspite of regular and appropriate medicine being administered. It can often lead to a series of side effects such as hopelessness, depression, anxiety disorders and traumatic stress.

Individuals suffering from chronic pain also end up with a number of long-term effects, including:

  • Inactivity owing to the fear of exacerbating their pain
  • Social withdrawal
  • Gaining excess weight due to inactivity, overeating or as side effects of medicines

Pacing – The Concept

Pacing is basically a therapeutic supplement for chronic pain management. It involves spacing the activities throughout the day in a manner that will help you avoid aggravating the pain further. Experts define pacing as a process of learning to effectively manage your activity and energy levels in order to manage your illness and the allied pain.

Also known as activity pacing, it is considered an essential component of occupational therapy in pain management to counteract the scheduling deformities in the daily life.

Pacing is a core concept in chronic pain management. It provides structure to the overall activity level and guides the patient to build an optimum schedule to minimize pain and maximize productivity during the day.

The logic behind the concept is that if you manage your energy wisely, it will gradually increase. Besides, pacing also brings about a structure to the day, giving the patient a sense of control.

The main aim of pacing techniques is to spread the activities evenly over the day and week to avoid occurrence of flare-ups in pain. Eventually, the techniques aim at helping the individual increase the overall level of activity.

In addition, another important aspect of pacing is to take regular short breaks before the pain becomes very strong and alternating between tasks and activities.

The Balance

The most critical aspect of the pacing process is the maintenance of balance. Here we discuss the two key concepts in this regard.

  • Underactivity

    Individuals suffering from chronic pain often fall into the trap of doing too little and gaining short-term relief from pain. However, this approach ultimately aggravates pain owing to decrease in muscle flexibility and a fall in the overall stamina.

  • Overactivity

    Contrary to underactivity, some individuals might even overstep their limits and keep on pushing at the activity inspite of pain and fatigue. In such cases, the patient suffering from chronic pain constantly faces fatigue, exhaustion and an ongoing flare-up of pain.

Pacing Techniques

There is a definite set of pacing techniques that are recommended for right scheduling of the daily activities.

Here we briefly discuss the main techniques of pacing.

  • Measure activity

    To begin with, it is important that you start making an exact note of the time spent on a particular activity in a day. In case a specific activity causes a considerable increase in pain later, pacing will be required.

    Once you have taken the readings for a sufficient number of times, calculate the average time taken for the activity.

  • Set the limit

    After the average time has been calculated, take off 20% from the figure. The remaining 80% will be the Limit. A Limit is the amount of activity which should be followed in a regular and disciplined manner.

  • Stick to the limit

    This is the most important part of the pacing process. It is important to have a sense of discipline and follow the limits strictly. Once the limit has been reached, stop doing the activity immediately, even if you are in the middle of it.

  • Increase the limit

    Once you feel a sense of control, you can then consider increasing the limit gradually. This will help you avoid further flare-ups of pain associated to that activity, besides increasing your stamina levels.


In this section, we give you a practical explanation to guide you for the implementation of the pacing technique appropriately.

The key approach here is trial and error. For instance, you may find that you can work at a certain activity for 30-minute periods, just with a 5-minute break after every half-hour.

If so, you can set a timer which will alert you to take rest after the decided time-gap. At the end of the day, you might realize that you managed to work productively for a total of 5 hours without increasing your pain, which was almost impossible with your chronic pain condition earlier.