In the past two pain blogs we have discussed what pain is and the effect of beliefs, thoughts and behaviour (you can find these articles here and here) . This week’s topic is pacing and establishing your baseline. Together these can create a very powerful tool to help you manage your pain.
The ‘Boom-Bust’ Cycle
Pacing is a technique to avoid using the ‘boom bust’ cycle of behaviour. ‘Boom Bust’ is when on a good day you try and fit everything in. You try and do as much as possible to catch up. Most frequently this results in a sudden increase in pain which could potentially knock you out for days. When this is repeated time after time we enter a vicious cycle of behaviour which reinforces pain.
Establishing a Baseline
Instead of the ‘boom bust’ cycle we want to introduce a more even level of activity, avoiding peaks and throughs. In order to do this we need to establish a ‘safety zone’ which is your baseline. This safety zone will be related to your goal. Make sure to have a goal to work with. You can read more about goal setting here.
Lets say that your goal is to be able to complete a specific activity for 30 minutes per day. . For this example I will use power walking as the activity. The first thing you to do is to establish how long you can carry out the activity of walking before any symptoms occur or escalate. Let’s say that at present you can walk for 7 minutes before your pain increases. To make sure that your baseline is comfortable we will therefore set your baseline at 6 minutes. This is your baseline. Your ‘safe zone’ where you feel that you can complete an activity for a specified amount of time without impacting on your symptoms. The next step would be to gradually build this baseline up towards 30 minutes. This may seem like a big jump, but the trick is to make it slow.
Increasing your Baseline Activity
For the first week you will for example walk for 6 minutes every day. By the end of the week, hopefully you will feel confident enough to increase this. We are looking at an approximate increase of 10% to avoid flare-ups. So using the above example this would mean increasing your walking to 7 minutes per day. Providing that there is no flare-up following the incerease, you will then again increase this by 10%. This can be done at the end of the week or when you feel confident to do so. The key here is confidence. By doing this slowly you will boost your confidence. On the other hand, if you rush it you may end up taking a step back instead, Rushing can. potentially create a spike in pain which subsequently can have a negative impact on your confidence.
This type of pacing will help you to slowly build your baseline up towards 30 minutes. You need to ensure that you give your body plenty of rest to recover. How much rest you need will depend on your baseline and you goal. In the above example I applied speed walking daily. As most of us need to get from A to B daily – walking daily is realistic. If your goal is targeted on for example running or gym, it is essential that you allow sufficient rest time between sessions as your body will need to recover. Therefore this might be an activity that you aim to start with around 2 days per week.
I hope you found these tools useful! Keep your eyes peeled for part 2 coming soon. To be the first to know, make sure to sign up to the mailing list!