Cymraeg
Persistent pain or fatigue can make it very difficult to keep active. It can also make you feel that on a ‘good day’ you need to make the most of the feeling and do as much as you can.
The following advice aims to explain how you can do everyday activities at home, at work and in your hobbies or social life without making fatigue or pain worse.
Most people base what they do and how much they do, on how they feel. Everyone gets tired. It’s expected after a hard day at work or strenuous activity. Tiredness is what you feel when we don’t get enough sleep. Fatigue is different, it’s a feeling of a lack of energy or exhaustion that happens even if you have your full 8 hours and cannot be relieved by sleep. Often people with long term pain or fatigue do more when the pain feels better or they feel less exhausted. This can mean that they often overdo things. This then leads to an increase in pain and/or feeling of fatigue and a decrease in activity.
Your body is designed for regular changes of position. Pain is aggravated either by too much activity or not enough for prolonged periods of time. The time intervals are specific to you. However human nature is such that you continue to do activities until the task is finished or the pain forces them to stop.
Pacing means keeping to the same amount of activity each day whether you are having a good day or a bad day. This may well mean that you do not do as much as perhaps you think you should on a good day!
If you can successfully pace everyday activities, you will find that you will achieve more over a period of time. You can do this by basing what you do on a plan and not on how you feel. If you can successfully pace activities, you will find that over time your stamina will improve. Your body will adapt and adjust and you will not have to keep taking time out for rests. Because you will have more stamina you will be able to do more without getting more fatigue and pain, Whilst pacing may be frustrating at first because you just want to get on and finish the task, you will find that pacing actually puts you back in control of your life. You can plan more reliably and don’t have to be controlled by fatigue or pain.
Pacing involves
- Spacing out activities throughout the day
- Performing tasks a bit at a time
- Working out time limits for different activities – people who have had pain for many years ignore the niggling signs that say the pain is gradually building up and getting worse
- Stopping and changing activity before your pain starts to increase
It is essentially about the 3 P’s to being in control:
- Prioritising
- Planning
- Pacing – this involves not doing everything in one go but taking a break before you need it
The aim of pacing is to plan and structure your day so that you are able to maintain a consistent level of activity.
It can take a couple of goes to get right but people often find that once they have got the hang of it, they are able to do more overall.
It is important that you apply pacing to all of your activity – work, home and leisure. To achieve this, it is important that you understand what your baseline is and when planning, ensure you have good quality rest periods.
How do I pace myself?
A lot of pacing strategies can help you live better with your condition. They include:
- Knowing your body
- Short activity periods
- Scheduled rest
- Routines
- Prioritizing
- Switching tasks
Don’t feel like you need to use them all — experiment and see what works for you
Time Limits
The first part of the plan is to work out what your limits are in some basic activities. This will help you to keep your activities the same.
The first part of the plan is to work out what your limits are in some basic activities. This will help you to keep your activities the same on both good and bad days. The time limits will be different for everyone.
Most activities involve either sitting, standing, walking and concentrating.
- Think about how long you could do each of these activities on a bad day and then write these down. Then think about how long you could do them on a good day and write these times down.
- Set your own limits for each of these activities beginning with your bad day time or time limit which falls between the two.
This means that you would sit, stand and walking using these time limits, changing your position for about two minutes at the end of each time limit if the limiting factor is pain or lying down and resting for that length of time if the limiting factor is fatigue.
To begin with you are pacing everyday activities using your ‘bad day’ times. This means that you are not going to make your pain or fatigue any worse because you can manage these activities on your bad days. The greatest difficulty for you will be not doing too much on your ‘good days’. To begin with it is a good idea to limit the amount of time spent doing one activity. For example, if the whole house needed to be hovered or the back and front lawn both needed to be mowed, then it would be sensible to do a total of only 20 or 30 minutes a day (including change of position or rest periods). This is because your body needs time to adapt to doing more.
Pacing examples
Set your own time limits for each of the activities beginning with your bad day time or a time limit which falls between the two. For instance:
| Bad day | Good day | Time limit | |
| Sitting | 5 minutes | 20 minutes | 5-10 minutes sitting |
| Standing | 1 minute | 5 minutes | 1-2 minutes standing |
| Walking | 2 minutes | 10 minutes |
2-5 minutes walking
|
| Concentrating | 10 minutes | 30 minutes | 10-15 minutes concentration but further limited by relevant sitting, standing, walking limits |
- Every time you did the hovering or mowed the lawn you would be using a walking position. So after three minutes you would stop and sit down for two minutes before starting again
- If you did the ironing or washing up you would stand for only two minutes before resting again
- If you were watching television you would sit for five minutes and then stand or have a walk around for two minutes before sitting down again. After ten minutes you would stop watching the TV altogether for a few minutes
Remember
- Good pacing means keeping to your time limits whether you feel good or bad
- This means not overdoing it on a good day or doing very little on a bad day, but doing a steady amount of activity every day
- In time as you improve your stamina will be able to increase these time limits and be able to do more without making your fatigue or pain worse
- You want to be in control of the fatigue or pain and if you wait until it is bad before you stop you will have overdone it and lost that control
- Resist ‘just five more minutes’ temptation – you may tidy up this task but you’ll do less tomorrow as a result, so it’s not worth it
- Know your limits and plan
- Little and often is best
- Quit while you’re ahead
If you would like to have a printed copy of the information above, please use this link
Additional links and information
The following websites have really helpful information on pacing:
My Live Well With Pain – Living Well Despite Your Pain
Flippin’ Pain
The Pain Toolkit Pain Self Management by Pete Moore
Education Programme for Patients (EPP) support can be very helpful find them on Facebook or the Gwent Association of Voluntary Organisations (GAVO) website.
IF you are a carer, there is support for carers of people with long term conditions through Carers Trust Carers Trust South East Wales
