For years, I kept doing the same thing over and over in my unmanaged chronic pain. You would think I’d have learned. I didn’t, at least not for a long time.
The pattern had a name, even though I didn’t know it yet. It was a roller coaster, and I rode it constantly. If you live with chronic pain, you probably know this ride.
The Roller Coaster
Here’s how it went for me. I’d have a good day. Less pain, feeling better. And because I felt better, I’d think about everything I needed to catch up on. So I’d start working and getting things done. Jim would ask, “Don’t you need to rest, or take a break?” And I’d say, “No, I’m fine, I feel good today, I’ve got a lot to catch up on.” So I’d keep going.
Part of what drove that was shame. I hadn’t been able to keep up with things around the house, and other people (my kids, Jim, friends and family) had been helping out. The shame of not keeping up pushed me to keep working while I could. A little pain would show up, but I’d tell myself it was manageable, I could push through and finish the job.
I’d work until the job was done. And that was usually right about the time my pain went out of control. The pain finally got louder than the guilt, so I’d worked and worked until I dropped.
Then I’d crash to the bottom of the roller coaster, and I’d have to rest extra because I was in so much pain. My typical crash was two and a half to three days of resting to get back to a level where I could move again without too much pain.
And here’s the trap. After those three days down, I now had three more days of housework and chores piled up. So the moment I felt better, I’d think, “I feel good today, time to get a lot done,” and I’d climb right back on the ride. Rinse and repeat. For 21 years.
What Finally Changed: Pacing
It took me far too long to learn the lesson. Eventually I was in a class on chronic pain, and it mentioned the idea of pacing. Pacing myself. Novel concept, right?
There are two kinds of pacing, and the difference is the whole point of this post.
Pain-based pacing is what I was doing. It means you keep moving until your pain stops you. It’s the most common type, because it’s natural. It’s what the short-term-thinking brain does. It wants out of discomfort and into getting things done, and it isn’t aware of the long-term consequences of those short-term choices.
Time-based pacing is different. You set a timer, or you decide in advance how long you’ll work on something, or you work until you finish one specific piece and then you rest. The key is that you’re not pushing your body to the point of pain every single time.
Why Time-Based Pacing Works
When you take regular, planned breaks, you stop teaching your brain that the only thing that ends an activity is pain so high that you drop.
This is hard. No matter how badly I wanted to stop, I always felt the pressure of “I have to get these things done.” But forcing myself to take those breaks changed everything. And here’s the part worth sitting with: at the end of the day, or even the end of three days, you’ve accomplished about the same amount. Even if projects take a little longer because you rest in the middle, they still get done. The difference is you’re not triggering your pain over and over.
That last point is the real insight. Pain-based pacing does something worse than just forcing you to rest for days. It trains your brain. Just like any habit, your brain learns that it needs to put out that pain signal regularly, because you’ve taught it, again and again, that pain is what stops you.
And this is critical: regardless of how much actual damage or underlying condition you have, you can still make pain worse by training your brain that it needs to keep firing that pain signal.
You’re Taking Control Back
Flip it around. If you change from pain-based pacing to time-based pacing, and your time-based breaks come earlier than the point where pain used to stop you, a few things can happen. You may have less pain. You may live more steadily instead of riding the roller coaster. And maybe most importantly, you’re retraining your brain to put out fewer pain signals.
You’re taking control, instead of letting pain always be in charge.
You don’t have to do this perfectly. Even if you just go up and down a little for a planned break instead of riding all the way to the top and crashing, that’s progress. Think of it as getting off the big scary roller coaster and onto the kiddie one. Smaller ups and downs, more manageable.
A Corner Piece of the Puzzle
Looking back, pacing was one of the most critical pieces for me to understand, especially because I’d spent so many years teaching my body and brain that pain was how everything got controlled.
Remember the chronic pain cycle, where I mentioned lying down all the time? This was why. I pushed myself to the brink, which forced me into two and a half to three days flat on my back. Once I started pacing and forcing myself to take breaks (which is not easy), my pain became more manageable and I stopped lying down all the time.
It was still just a piece. Not the silver bullet, not the magic pill. But it was an important corner piece of the puzzle that helped me start living in a way where pain was no longer in charge.