What is pacing?

Pacing is a strategy that is often used by people with chronic illness to allow them to complete activities but not significantly worsen their symptoms. When mastered, pacing may also positively impact people’s confidence in their ability to manage their condition (also known as self-efficacy).  

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In migraine, pacing is used to maintain a level of functional independence without causing an undue increase in headache intensity and associated headache symptoms. 

Why should I pace?

Many people with migraine report that stress and overexertion can start a headache or make an existing headache worse.  Hectic schedules can impact both of these factors. They can heighten stress, particularly if the schedule is especially unrealistic, and they can reduce the available time for headache protective factors.  For many people, this doesn’t end well. Their symptoms increase, they have to cancel plans or withdraw from activities, and they often end up in bed. Tasks don’t get done, headaches get worse, and self-efficacy takes a nosedive.

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With pacing, people schedule their daily and weekly tasks in moderation and in advance.  They include enough time for rest breaks, nourishing meals/snacks, and sufficient fluid intake.  They also build in buffer time to account for traffic, unexpected family issues and other factors that are beyond their control.  Pacing, if done consistently, can decrease stress levels, boost the use of important headache protective factors, maintain or decrease headache intensity, and increase self-efficacy. 

Pacing sounds quite demanding.  Why is it So Hard to Make this Change?

We live in busy times!  There are always tasks to do.  Many people rely on us. People put unrealistic expectations on themselves or say “yes” to every request to avoid disappointing people…or losing their jobs. Busy schedules preclude rest breaks and good headache management.   

No matter the situation or the motivation, completing tasks without a break and against a backdrop of high stress is not sustainable for people with migraines. See it this way: it is better to plan and prepare than crash down after a rush. 

The “I-have-to-do-everything-all-the-time-to a high-degree-of-perfection” mindset has to go!  

Consider the following alternatives before you begin to pace: 

  • I have limited time.  I have to choose what’s most important and defer, decline, or reschedule the rest.
  • Doing too much can increase my stress and fatigue and cause or worsen a headache.
  • Making time for headache behavioural strategies in my day can help prevent my stress and fatigue levels from getting too high.  
  • I have to plan activities in advance. Being impulsive or spontaneous is okay, but should be done carefully.
  • My schedule has to be flexible and I need to make adjustments when unexpected things happen or if my headache flares

Learning how to use pacing can lead to a better life for you and your loved ones. 

To learn how to do it, read this page (LINKIN 611

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