Chronic Pain and Pacing
Cathy Price, a pain consultant joins us today to talk about chronic pain and pacing.
Here are some links to pacing guides. If your recovery from injury is much slower than you anticipated or if simply pain isn’t going away then building up fitness isn’t simply going to be sorted by pushing through pain. The rule of no pain no gain doesn’t work.
Do you find yourself getting good days then bad days?
Is pain much worse towards the end of the day?
Then it’s likely you are in an over activity under activity cycle like the above. The arrow at the top shows that when you are feeling good and you are frustrated about the amount you can do, you tend to do as much as you can. The bottom arrow shows the dip that happens as a result.
At the peak we have asked our bodies to do more than it can manage and in a sensitised nervous system it means the body over reacts and falls into a trough, increasing pain sensitivity and causing soft tissues to spasm and weaken. Over time you actually do less rather than more. I mostly see people when they are at the far end and very depressed, angry and frustrated. With a bit of help most people can turn this round. Pacing is one way of doing this.
Pacing isn’t staying at the same rate. It’s a way to build up activity in a planned way. You take a baseline that you can do every day and stick to that for a few days , once you know you can do it add in a little bit more, that way the nervous system doesn’t get overwhelmed and you get fed up.
If you want to get back to running then setting a baseline means first of all timing a comfortable run until pain kicks in. Notice what the time was. Then drop this by 10-20% and this is your baseline (as your brain notices it’s hurting a bit late). Stick to this amount for three days and then trying adding in 10%. Do the same again. That way you should start climbing out of the cycle.
The only way you will do this is if you manage frustrating thoughts that kick in and cause us to over do…like…this is ridiculous, I’m never going to get back, I feel so stupid….
If it’s difficult then a trained therapist will help you do this successfully by helping you with planning and adjusting the plan.
Here are some useful resources:
www.ouh.nhs.uk/patient-guide/leaflets/files/11850Ppacing.pdf
https://www.paintoolkit.org/pain-tools/pacing
Cathy Price
Pain Consultant
If you want help then at Physio-logical we take time to listen to you and work together with you to make a plan and set achievable goals. To book to see us then please book online, email or call us on 07835 712306
