Pacing Activities

What Is Pacing?

Pacing is a strategy of breaking up activities into manageable chunks, alternating between activity and rest to prevent symptom flares. It helps avoid the "boom-bust" cycle where good days lead to overdoing it, followed by days of increased pain and inability to function.¹

The Boom-Bust Cycle

Good day → Do too much
Overactivity → Flare/crash
Recovery period → Feel better
Repeat cycle
Results in unpredictable function
Can increase overall disability

Benefits of Pacing²

More consistent daily function
Fewer severe flares
Better energy management
Gradual increase in tolerance
More reliable routine
Less frustration and disappointment

Key Principles

Know Your Baseline

Determine how much you can do consistently
Activity level that doesn't cause flare
Usually less than "good day" capacity
Track for several days to find it

Break Up Activities

Divide large tasks into smaller parts
Take scheduled rest breaks
Stop before symptoms increase
Use timers as reminders

Alternate Activities

Switch between activity types
Alternate sitting and standing
Mix physical and mental tasks
Balance demanding and easier activities

Practical Strategies³

Set time limits for activities
Use "activity quotas" (time-based not pain-based)
Plan ahead for demanding days
Rest before exhaustion
Say no when needed
Prioritize important activities

Common Pacing Mistakes

Resting only when exhausted
Overdoing on good days
Not scheduling enjoyable activities
Being too rigid
Comparing to pre-pain abilities

Pacing vs. Avoiding

Pacing maintains activity at sustainable level
Complete rest/avoidance causes deconditioning
Goal is steady activity, not no activity
Gradually increase baseline over time

Getting Started

Track activities and symptoms for a week
Identify your baseline capacity
Practice breaking up one activity
Add scheduled rest breaks
Adjust based on results

References

Murphy SL, Kratz AL. Activity pacing in daily life: a within-day analysis. Pain. 2014;155(12):2630-2637.
Nielson WR, Jensen MP, Karsdorp PA, Vlaeyen JW. Activity pacing in chronic pain: concepts, evidence, and future directions. Clin J Pain. 2013;29(5):461-468.
Gill JR, Brown CA. A structured review of the evidence for pacing as a chronic pain intervention. Eur J Pain. 2009;13(2):214-216.