Energy management refers to being able to begin increasing physical activity so that you can begin to feel fitter and healthier. Deciding what is a priority and what can wait assists with choosing the most needed tasks in your life. Pacing will provide you with an effective means of achieving your goal, provided you are realistic in choosing to activate the priorities.

Pacing is about scheduling activities over a period of time so that you have a balance of ‘planning’ and ‘doing’ activities. This involves following a routine of less pleasurable activities by pleasurable activities and adhering to the routine as closely as possible. The enjoyable activities should follow the chores, rewarding yourself for your achievements.

Often individuals with persistent pain will have ‘better and bad days’. It is important not to save up physical activity for the good days and then go hard at it. If this happens you will surely feel those bad days and then need some time to rest and recover ie days or weeks. This is called the “Boom-Bust Cycle”. To achieve a more even balance it is better to do less on the good days and more on the bad days. This will involve being as active as you can manage, without significantly increasing the pain. An increase in muscle pain is to be expected though, when you are using muscles and joints in new ways. At times, doing more than you can manage (significantly increasing pain levels) might be inevitable eg demands of children. However, if the boom-bust cycle becomes habitual, it can result in a number of side effects:

• Exhaustion
• Mood swings
• Appetite and weight changes
• Sleep disturbance, insomnia
• Making more mistakes eg forgetting to do things or dropping things

Watch out for Boom-bust signs

• Being highly motivated to achieve a goal, to the point where you push yourself and significantly increase pain levels
• Bending to pressures from those around you to the point where you significantly increase pain levels
• A high number of commitments/ responsibilities to meet which significantly increase pain levels
• Being apprehensive about what may happen if things don’t get done to the point where you significantly increase pain levels

Performing one major task in small steps a day can lead to a feeling of achievement and build your coping strategies but it will take time and patience. Try and not compare yourself to what you used to be able to achieve before the onset of chronic pain – this is probably not realistic now. Pacing and balancing tasks become skills that can assist with managing chronic pain.