Chronic Pain Clinic - Week Two - Pacing

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Pacing is one of the more difficult things to do for a Chronic Pain sufferer. We know we can't do things but we don't want to believe it. Plus, we have things that NEED to be done! Sometimes we are in the middle of cleaning the living room, for example, and we know we have done too much but there is just a little more that needs doing. It is a calculation we do, it is illustrated by the 'Spoon Theory' which I will share in a minute. We calculate how bad it will hurt to finish what we are doing, and in the end we pretty much always go for the more extraneous activity, that extra push, and we gamble paying for it later.

This is a nightmare for procrastinators...like me. If I am doing something physical, usually it is walking my dog or cleaning a part of my home, even showering is difficult for me. I call the shower a torture chamber. These activities NEED to be done. I have trouble with the pacing because I want to get these things, these painful, difficult things, DONE. This is a terrible way for someone with Chronic Pain to treat their bodies.

Most chronic pain sufferers have had trauma in their lives. I have. I endured a terrible trauma when I was a little girl. I, apparently, stuffed that experience away somewhere in my mind and because I did, I was able to survive. I was able to 'live a normal life'. In reality, I never really stuffed that experience completely away and it begun to eat at my soul. 30-some years later that event manifested itself in the form of pain. All my doctors, and I have had a LOT of DOCTORS!!! are now saying the same thing:

"It's all in your head"

Well THAT'S a jagged pill to swallow. No one who has an invisible illness, like Rheumatoid Arthritis, Fybromialgia, Neuropathy, etc...wants to be told It's all in your head! because it is NOT. The pain is freaking REAL. This pain I have is so real it has taken over my life. It has taken away everything I love. I can not drive, I can not go on vacation, I can not go out of my house, I can not clean, I can not SHOWER for God's sake!!! This pain is real!!!!!!!

and breathe

The doctors are right though. It is all in my head. Not the pain, that IS real. The ailment though. That is in my head. That is where the doctors need to go in and fix me. that is how I will be out of pain. Now, how does this tie into pacing you ask? I have learned that people who suffer trauma can not handle change. This means ups and downs cause MORE pain than necessary. If I try to do too much then suffer the consequences it will be worse for me than if I pace myself. An example would be, say I am vacuuming the house. I am standing there with the vacuum, I think to myself, why not vacuum the entire house? (Sadly, I have wall to wall carpeting, lame, I know) If I vacuum the entire house, I use up too much energy, energy I don't have so when I finish vacuuming the entire house I am bedridden for a day. That is a but up and a huge down. Conversely, if I vacuum one room, I am reserving that energy and I only have to sit down for an hour to recover. This is considerably healthier for my body( and my mind while we are at it).



Enter: Pacing

In order to pace yourself you need to plan and prioritize. Here is where explaining the Spoon Theory comes in handy. To summarize, The Spoon Theory is imagining your life with chronic pain like waking up every morning with a set amount of spoons. People without an invisible illness have an unlimited amount of spoons. We have a set amount and that amount changes every morning when we wake up. Moving through the day, things cost us spoons. Taking a shower may cost a couple spoons, making breakfast, for me, walking the dog takes a lot of spoons. As the day progresses, we are spending spoons. When it comes to the end of the day we may only have one or two spoons left and we need to think, do I spend them on a shower or making dinner? Or perhaps we have no spoons left at all and we have to leave our child at soccer practice. I joke. We are not monsters. Even though I greatly dislike kids, I would never leave one at the soccer field. I digress. This gives you a way to visualize how much 'gas' we have to get through the day. It is a way to plan and prioritize.

Here is how you are going to do it:

Get a piece of lined paper out. Draw a line down the middle from top to bottom. On the left side write things you have to/want to do in a day or week that is High Impact. For me I have wash dishes, walk dog, grocery shop...you get the idea. Next to the activity you can jot down the time it takes to do that activity too if that helps. On the right side of the paper write down a list of low impact activities. These are activities that you may not have to do but things that help calm you down, help relax you. I have things like meditation and couch snuggling on mine. It helps to write down the time next to those activities too. The time you write is sort of the time it takes you to drop down a pain level or two.


Now you can plan your day by picking an activity from the left hand column, then, right after that, pick one from the right. Alternate like that throughout your day. This is how you get things done. Try to pick high impact things that only raise your pain level a MAXIMUM of two points. Then you must STOP and do a low impact activity, like play a computer game for an hour, until your pain goes back down. This will not only make your life more productive, it will be easier on your traumatized body. The body that does not like change.