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Pain management: pacing and activity management

What is pacing and activity management?

Activity management is a set of skills used to help manage persistent pain. It involves working toward a balance and variation in day-to-day activities, on both good and bad days. It means not overdoing activities on a good day and not stopping activities or resting too much on a bad day. It can take time and practice to make changes to your daily routines and habits, so it's important to be patient with yourself.

What are the benefits of pacing and activity management?

Over time, it can help you gradually increase your activity levels without flaring up your pain, which may help with your sleep and overall energy levels. 

The four Ps of activity management

Prioritising

This is the first step in activity management and it requires thinking about your day-to-day commitments. Consider the following:

  • What are the most important things that need to be done first?
  • What commitments have I already made?
  • Does the task need to be done today or could it wait until another day?
  • Does the task need to be done at all?
  • Do you need to ask for support from friends and family?

Planning

Once you have prioritised what needs to be done, the next stage is to plan your tasks over both the day and week, making sure activities you find difficult are spread out. It may be helpful to use activity scheduling sheets or timetables. Consider:

  • Can you break the activity down into different stages?
  • Can you include frequent changes of position?
  • Are your plans realistic?
  • Have you included activities that you enjoy? (Not just jobs!)

Pacing

Once you have prioritised and planned your activities, you will need to use pacing skills to carry them out. Most tasks have differing demands and intensity levels; they may be physical, cognitive, or emotional. Consider:

  • The physical demands of the task e.g. sitting, standing, walking, lifting, carrying items
  • The cognitive demands of the task e.g. you may need to remember things, organise yourself, concentrate, calculate, write, read
  • Whether the task involves or provokes any emotional responses e.g. frustration at your limitations, worry or anxiety about yourself or others, anger, confidence, and self-esteem issues
  • Work out your baselines for sitting, standing, and walking and apply them with the help of a timer or some other prompt

Problem solving

Changing habits can be challenging. It is important to take some time to review the situation.

  • Was your baseline realistic?
  • Did something unexpected interfere?
  • Are you ready to step up your activity levels?
  • Have you got an even distribution of different types of tasks?
  • Do people around you understand what you are trying to achieve?
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