Pacing one’s activity

Pacing one’s activity is an important component of recovering from pain. Patients with severe pain try to perform as many tasks as possible when the pain is manageable. Unfortunately this over activity results in debilitating pain and they are then unable to perform even basic self-care activities for the subsequent few days. They go though these periods of over activity and under activity which unfortunately increases their frustration.

As humans we want to do better and the basic instinct is to do as much as one can. It is common to find patients trying to force themselves through the pain barrier. This unfortunately only leads to more pain.

This is akin to going on a spending spree on receiving a credit card and then finding oneself chained to a huge debt. The credit card then becomes unusable until the excess amount above the credit limit and the charges have been repaid. Some charges can also be very steep. Wisdom is to remain within the credit limit.

Similarly it is important to pace oneself when recovering from back pain. It is important to realise, that like a “credit limit” on a credit card, there is a “pain free activity limit” when recovering from back pain. It is important to stay within that limit. If walking 200 yards causes pain, then it is important not to walk more than 200 yards in one go and only walk 150 yards at any one time. After walking 150 yards take a short rest and then walk another 150 yards. It is more scientific to walk 150 yards many times over whilst resting for short periods in between. Walking 250 yards in one go and over the pain barrier may only result in severe pain and an inability to move further. On the contrary, someone walking within the pain free activity limit, may walk 150 yards about 10 times with 5 min of rest in between and totally walk 1500 yards.

George Ampat

Consultant Orthopaedic Spinal Surgeon, Feet and Spine

www.feetandspine.com

Reference

Pacing: a concept analysis of the chronic pain intervention. Jamieson-Lega K, Berry R, Brown CA. Pain Res Manag. 2013 Jul-Aug;18(4):207-13.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3812193/pdf/prm18207.pdf