Pacing

What Is Pacing?

Pacing is a self-management strategy that involves balancing activity and rest to avoid triggering pain flares. It helps break the boom-bust cycle where overdoing it on good days leads to days of increased pain and inactivity.¹

The Boom-Bust Cycle

• Good day → Do too much (boom)
• Next days → Severe pain flare, forced rest (bust)
• Recover → Repeat the pattern
• Results in inconsistent activity and overall decline

How Pacing Works²

• Set time limits, not task completion goals
• Take regular breaks before pain increases
• Maintain consistent activity level day to day
• Gradually increase activity over time
• Plan ahead for demanding days

Practical Strategies

Time-Based Approach

• Determine your baseline (sustainable time for activities)
• Set timer for activity periods
• Take scheduled breaks (5-15 minutes)
• Switch between different types of tasks

Priority Setting

• Identify must-do vs. nice-to-do tasks
• Spread demanding tasks across days
• Delegate when possible
• Learn to say no

Finding Your Baseline³

• Track activities and pain levels
• Find the point before pain increases
• Start at 80% of that level
• Be consistent for 1-2 weeks
• Gradually increase (10% at a time)

Common Challenges

• Feeling lazy on good days
• Guilt about not finishing tasks
• External pressures and expectations
• Unpredictable symptom patterns

Benefits

• Fewer severe flares
• More consistent daily function
• Gradual activity increase over time
• Better sense of control
• Improved quality of life

References

1. 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.
2. Antcliff D, Keeley P, Campbell M, et al. Activity pacing: moving beyond taking breaks and slowing down. Qual Life Res. 2018;27(5):1249-1256.
3. 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.