Chronic pain is complex! Our brain and nervous systems are very powerful, containing galaxies worth of neurons working simultaneously to keep us alive and active.We have discovered a lot about these networks but have so much more to learn about how they truly work and behave.
‘With power comes great responsibility’
And in some cases, our brain and neural networks can work for us or against us. Unfortunately, chronic pain is the latter. With chronic pain, your neural networks are sensitive, firing ‘false pain signals’ more frequently and powerful than usual.
People with chronic pain commonly have ‘flare ups’.
Regular flare ups can strengthen pain networks and increase their sensitivity. If this happens regularly, your tolerance for daily activities will continue to diminish with time.
One of the most useful techniques to manage ‘flare ups’ is called ‘pacing principles.’
It is not easy; It requires planning and discipline. But when done correctly, you will feel in more control of your pain than ever before.
Pacing can be done in 3 simple steps:
- Identify your baseline: find your current tolerance to activities without flaring up your pain, e.g. walking 20 minutes, ironing 4 clothing items, sitting 60 minutes. If you are unsure, I recommend underestimating your ability and working from a lower capacity.
- Plan your day/week: spread out and/or shorten your tasks, so that they work within your baseline. Do activities for less time but more frequently throughout the week e.g. small bouts of household cleaning each day rather than one big day per week. Take regular breaks and keep an activity diary to stay aware of your daily tasks, this help refine your baselines and identify patterns (what truly flares you up).
- Add additional activity gradually: Once your pain settles and you feel in more control, slowly add more time to your baseline. Make sure to avoid adding more than 10% per week to your baseline measurements.
And most importantly, be kind to yourself, this is a slow and steady process, we all slip up once in a while.