Activity pacing: Learning to better manage chronic pain

Dr. Aurelie Lucette • Jun 30, 2020
  • You often push yourself until you’re in so much pain that you have no other choice than to stop, being forced to rest for long periods of time.
  • When you have a good day, you try and cross off as many things as possible on your to-do list.
  • You don’t like to stop until you’ve completed a task.
  • You’re used to getting things done, and slowing down has been a struggle.


Does that sound familiar?


If you live with chronic pain, chances are that a loved one or medical provider has told you before that you need to slow down or pace yourself. 

Activity pacing is a tool designed to help decrease pain flares and improve functioning by pro-actively scheduling periods of activity and rest. 

Activity pacing helps with:


1. Promoting increased functioning and doing more of the things that matter to you.


2. Preventing avoidance of physical activity or overexertion. Doing too much or too little can have detrimental consequences. 


3. Decreasing the frequency of pain flare ups.


4. Feeling more in control of the way your days unfold as you learn to engage in periods of rest and activity proactively. 


What activity pacing is NOT


  • Being forced to rest after pushing yourself too much.


  • Overdoing it on a good day and staying busy until the pain flares up and your body is begging you to stop.


  • Staying in bed to avoid pain or symptom flare ups.


  • Getting everything done on your to-do list when you feel well.


  • Having to complete a task before you take a break and rest.


  • Requiring extended rest after overdoing it and experiencing intense pain.


The statements listed above describe the pain cycle, which refers to long periods of forced rest to allow your body to recover after pushing yourself too much. This cycle can contribute to increase in pain and is likely to make you feel defeated, tired, and overwhelmed.




What activity pacing looks like


  • Termination of an activity is time-contingent, not pain-contingent.


  • This is the most important aspect of activity pacing. The idea is that you end an activity after a set period of time, rather than when pain starts to flare.


  • To determine your baseline, record the average amount of time you can engage in a given activity before the pain flares.


  • After determining your baseline, set a time target for periods of activity. The starting goal should be less than your baseline. Reduce your baseline by 20% (you can do that by multiplying your baseline by 0.8). For instance, if pain flares after 20 minutes of walking, start with a 16 minute-walk (20*0.8=16 minutes). You will then gradually increase your activity, as tolerated.


  • It is expected that each activity will have a different baseline. For instance, back pain may kick in faster when walking than when lying down.


  • You may want to start pacing yourself with activities that you tend to overdo on a regular basis (e.g., house chores, working at your desk, exercising).

Rest can look like many different things: Answering emails, meditating, ordering groceries online, making a phone call, writing, taking a nap, stretching, etc
  • Pacing may be challenging if you’re used to doing things non-stop. Scheduling periods of activity and rest on your phone or writing them down on a calendar can help keep you on track.


  • Use a timer to remind you to stop an activity!


  • Record your progress by keeping track of pain levels and feelings of accomplishment and mastery throughout the day. Adjust your goals as appropriate.


  • Spread activities evenly throughout the day and week (e.g., don’t plan to accomplish all house chores on Monday!)


  • Maintain a flexible schedule. Life happens. You may need to squeeze in a last-minute meeting or trip to the store. Avoid crowded schedules of activities to allow for unexpected to-do’s.


  • Be gentle with yourself! This may be the most important piece of advice here. Changing the way you do things is tough! If you find yourself feeling frustrated, anxious, or upset, don’t give up! Challenging the way we do things often forces us to rethink the way we are, which can take time. Learning to apply pacing to your life will likely take trials and errors. BE KIND TO YOURSELF as you learn this new skill. 


This blog post offers an overview of activity pacing. Learning to apply this skill may require some help and additional guidance. Therapy can offer a venue to guide your progress as your learn to better manage chronic pain in your life. 






I am Dr. Aurelie Lucette, a clinical health psychologist who provides individual therapy in Miami and online throughout the state of Florida. I can help with issues related to anxiety, stress, sleep, and depression. I also specialize in therapy for adults living with cancer , chronic illness, chronic pain.


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