Pacing is an effective strategy that allows people with migraine the ability to maintain functional independence without causing an increase in headache intensity.  Many people with migraines report that stress and overexertion can be consistent triggers.   With pacing, people can keep reasonable schedules and workloads and, as a result, keep stress and exertion to manageable levels. Pacing also involves prioritizing, biomechanical principles, and lifestyle balance, and is closely tied in with personal values.  Here is how pacing works:

Step One:  Make a List of What You Have to Do and Want to Do Each Week
Prioritize the items on the list using a system of your choice.  (For example, put a “1” beside things that are most important, “2” beside things that are next most important, and so on, or use a colour-coded system.  Highlight in green things that are most important, yellow things that are next-most important, and red things that can be postponed or not done.)  Delegate tasks to others when necessary, and don’t forget that saying  “no” is an option.  Use your values to help prioritize tasks.  For example, if time with your family is important to you, make sure to include family-based activities.

Step Two:  Place Items in a Weekly Schedule
Fill in a weekly schedule with your items.  Ensure multi-step and/or heavy tasks are broken down into manageable chunks that can be scheduled throughout the day or over the course of a week (e.g., do one load of laundry each day instead of a mountain of laundry every Saturday).  Alternate work with mini-rest breaks and heavy tasks with light ones.  Schedule in rest breaks and meals.  Don’t make your schedule jam-packed.  Leave a little extra room in case of anticipated delays or problems. Earmark activities that can be modified or removed, so that if you have a headache that day, you can easily eliminate or reschedule items.  Some people like a mid-week break and don’t schedule much on Wednesdays. Plan to purchase healthy pre-made, frozen dinners, or take-out some nights so that meals don’t always have to be made from scratch.  A slow cooker is a wonderful idea.  While supper is cooking, you can catch up with your family or do some relaxation exercises.

Step Three:  Use Good Body Mechanics, Energy Conservation, and Frequent Position Changes
Make sure that you keep your work close to you (or you close to it) for both horizontal and vertical surfaces.  Maintain your spine’s natural curves: lift with your legs; push instead of pull; slide items or use carts instead of carrying them; store things at waist level to avoid low-level lifting. Eliminate unnecessary steps (e.g., avoid repetitive stair climbing by keeping duplicate sets of cleaning supplies on each floor or waiting until you have a few items to transport before heading up the stairs).   Don’t stay in one position for too long.  Remember to alternate sitting with standing.

Step Four:  Relax Your Standards
Don’t strive for perfection.  Remember your values.

Step Five:  Incorporate Life Balance
Draw a circle and divide it into 24 equal wedges.  Label each wedge one hour in the day (e.g., from 12 a.m. to 12 p.m.).  Add a colour-coded legend to the bottom.  Have one color represent “work”, another “work at home”, another “leisure or play”, another “sleep”, and another “rest”.  Colour in your balance wheel accordingly.  Monitor your wheel from time to time to see if there is balance between these areas and if not, where you might make some adjustments.