Staying Active with Pain: Activity Pacing
How pain impacts physical activity
Cancer pain can make it difficult to be as active as you want to be. With pain people naturally spend more time resting. Sometimes people save most of their physical activity only for “good days.” Afterwards they pay the price with a pain flare that leaves them needing to rest and recover for days and feeling sad and helpless. As a person rests for a long time, their muscles become weak, it becomes harder to be active, and pain worsens.
This experience is very discouraging, and it is very common. Psychologists call this the pain cycle. The good news is that there are tools you can learn to take control and break the pain cycle.
Activity pacing:
A tool that has been proven to break the pain cycle and help get you back to activities that are important in your life.
In a nutshell, this tool focuses on doing realistic physical activities for short periods of time, taking scheduled rest breaks, and slowly increasing your activity level up over weeks to months. Taking pain medicines before the activity can be very helpful. Over time this technique can help you build up your strength, endurance, and help you do more of the activities that matter to you. Many people also notice their pain feeling better, and feeling happier doing the things that they love.
The Pain Cycle
Breaking the Pain Cycle
Pain
Resting
Sadness
Weakness
Avoiding activities
Activity Pacing
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Start easy
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Slowly increase amount
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Take regular breaks
Reduced Pain
Safe, manageable physical activity
resting
Reduced
Sadness
Stronger muscles
weakness
Doing
avoiding activities
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Always follow the instructions on your prescription bottle.Never take a higher dose of your opioids, or take them more often than prescribed. Instructions on medicine bottles can be confusing. Short-acting opioids are often prescribed with a range of doses you can take. For example: “Take 1-2 tablets every 3 hours as needed for pain.” This means it’s OK to take up to 2 tablets within a 3-hour time window. You can also choose to take less than this, or not take it at all (if your pain is controlled). Take them with a sip of water, with or without food.
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Take them when you have pain and need quick relief.These take about 30 minutes to start working and 1 ½ hour to get the most relief, so take them early on when you feel your pain creeping up.
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If you don’t have pain, don’t take them.If your pain is manageable and you don’t expect it to get worse, you shouldn’t take this medicine. It should be used “as needed” when you have pain.
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Take them before your pain gets severe.Try to “stay ahead” of your pain by taking your short-acting opioid early on when you notice your pain getting worse. If you wait until your pain is severe, it often takes more medication and a longer time to get your pain under control. Pay attention to your body as you learn about your pain and how you react to opioids. Most people start recognizing their body’s signals about when they need to take their short-acting opioid for breakthrough pain.
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Choose the dose that matches your pain level.Most short-acting opioid prescriptions have a range of doses you can choose to take within a given time-period. A common example is take 1-2 tablets every 3 hours as needed. If your pain is severe, start with the higher dose (for example: 2 tablets). If your pain is less severe, you can start with the lower dose (for example: 1 tablet). If your pain isn’t significantly better after 30 minutes to an hour, you can take the rest of the dose.
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Take them about 30 minutes before painful activities.Some people know they will have pain with certain activities, like walking or taking a long car ride. Think of activities that usually worsen your pain. To help you be more active, you may want to take your short-acting opioid 30 minutes beforehand.
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If your short-acting opioid is not working well, talk to your care team.Every person is different and it can take some time to find the right medicines and right doses for you. Your care team might decide to increase the dose of your opioid or change to a different medication. The important thing is to let them know how you are doing.
Here is an overview to the steps of activity pacing:
Tips to help you succeed with activity pacing:
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Always follow the instructions on your prescription bottle.Never take a higher dose of your opioids, or take them more often than prescribed. Instructions on medicine bottles can be confusing. Short-acting opioids are often prescribed with a range of doses you can take. For example: “Take 1-2 tablets every 3 hours as needed for pain.” This means it’s OK to take up to 2 tablets within a 3-hour time window. You can also choose to take less than this, or not take it at all (if your pain is controlled). Take them with a sip of water, with or without food.
-
Take them when you have pain and need quick relief.These take about 30 minutes to start working and 1 ½ hour to get the most relief, so take them early on when you feel your pain creeping up.
-
If you don’t have pain, don’t take them.If your pain is manageable and you don’t expect it to get worse, you shouldn’t take this medicine. It should be used “as needed” when you have pain.
-
Take them before your pain gets severe.Try to “stay ahead” of your pain by taking your short-acting opioid early on when you notice your pain getting worse. If you wait until your pain is severe, it often takes more medication and a longer time to get your pain under control. Pay attention to your body as you learn about your pain and how you react to opioids. Most people start recognizing their body’s signals about when they need to take their short-acting opioid for breakthrough pain.
-
Choose the dose that matches your pain level.Most short-acting opioid prescriptions have a range of doses you can choose to take within a given time-period. A common example is take 1-2 tablets every 3 hours as needed. If your pain is severe, start with the higher dose (for example: 2 tablets). If your pain is less severe, you can start with the lower dose (for example: 1 tablet). If your pain isn’t significantly better after 30 minutes to an hour, you can take the rest of the dose.
-
Take them about 30 minutes before painful activities.Some people know they will have pain with certain activities, like walking or taking a long car ride. Think of activities that usually worsen your pain. To help you be more active, you may want to take your short-acting opioid 30 minutes beforehand.
-
If your short-acting opioid is not working well, talk to your care team.Every person is different and it can take some time to find the right medicines and right doses for you. Your care team might decide to increase the dose of your opioid or change to a different medication. The important thing is to let them know how you are doing.
