Managing Chronic Pain With Pacing

Typically, minor discomfort from injuries or accidents goes away over time. But sometimes pain can linger for longer, no matter what you do. Chronic pain is considered physical pain that lasts for three months or more, beyond the usual recovery time.

This kind of pain in the body can be constant or come and go with “flare-ups,” which are periods when our pain is more intense than usual. 

Emotional distress can also be associated with long-term discomfort. For example, we might feel persistent stomach or chest pain during a period of prolonged stress like job interviewing, divorce, or times of uncertainty.

Discomfort caused by distress can also show up as burning, aching, stinging, throbbing, tightness, tingling, numbing, or fatigue. Emotionally, we may feel sadness, anxiety, anger, irritability, frustration, or loneliness.

If this sounds like you, you aren’t alone. More than one-quarter of Americans cope with chronic pain, but there are resources to help. 

Ways we tend to manage chronic pain

Many of us respond to pain using one of two opposite approaches: pushing through or avoiding activity. We may also alternate between these approaches.

Pushing through pain means continuing to do whatever we’re doing as if our pain isn’t there. Examples of this may include:

• Carrying heavy grocery bags despite experiencing shoulder pain
• Finishing a workout class while feeling neck pain
• Staying seated through dinner in spite of a back pain flare-up

Pushing through chronic pain can trigger injuries that require a longer recovery period, creating a cycle that’s difficult to escape. 

The opposite approach to pushing through pain is avoiding activity. When we avoid activity, we severely limit our movement in response to pain. Examples of this may include:

• Lying in bed all day when the pain spikes
• Declining a social invitation because we’re afraid it would cause physical discomfort
• Eating fast food because cooking and cleanup might be too stressful and cause a flare-up

Avoiding activity can seem like a way to prevent pain or conserve energy for important tasks. But over time, it can lead to muscle weakness and joint stiffness, making it harder to do the activities we used to do. It can also lead to poorer mental health outcomes, like depression.

Coping with chronic pain through pacing 

Since pushing through and avoiding activity tend to worsen pain in the long term, it’s important to find a balance between these approaches. “Pacing” is a middle ground that can help us manage chronic pain and participate in activities that matter to us.

Pacing involves breaking activities into smaller chunks so that we can participate without risking flare-ups or additional injury. When we experience fewer flare-ups, we tend to feel better, spend less time recovering, and accomplish more.

Before starting a pacing technique to deal with chronic pain, consider your schedule and how you can break up tasks over time. For example, rather than cleaning your entire home in one day, clean different rooms over the course of a week.

Try pacing by following these simple steps:

• Pick an activity you do often or an activity you will do soon that causes pain. Example: mowing the lawn.
• Guess how long you can do that activity before experiencing discomfort. Example: 25 minutes.
• Subtract 1–2 minutes from your guess. This number is your “goal active time” for the activity. Example: 23 minutes.
• Consider how long you might need to rest after this activity to feel comfortable again. This is your “goal rest time.” Example: 30 minutes.
• Do the activity for the duration of your goal active time, and then recover during your goal rest time.
• Reflect on your experience. How accurate were your goal active and rest times? What adjustments might you make the next time you do this activity?

As you complete a pacing technique, consider keeping a notebook handy to track your progress or an alarm clock to help you stick to your goal active and goal rest times. Journal how you’re feeling and if any strong emotions are coming up that may lead to more physical discomfort. 

How to help a loved one managing chronic pain

Providing emotional support to a loved one who is coping with chronic pain can help them feel less alone and maintain a sense of normalcy. Here are some ways you can help:

• Understand that your loved one may have good days and bad days.
• Research their condition and ask about their pain and discomfort levels.
• Join them or help schedule their next doctor’s appointment.
• Provide reassurance that you’re there for them and their needs.
• Respect their physical capabilities. For example, if they need to lie down or decline an invitation to go out, listen without judgment. 

Emotional support can help

If you’re experiencing chronic pain, a medical provider can evaluate your symptoms and suggest treatments. A mental health expert can also offer tools to support you in coping with chronic pain. That’s where Lyra comes in.