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Building your Toolbox: Pacing/Boom-Bust Patterns

Updated: Jun 20, 2023

By Amy Gowland



Who hears the word pacing and wants to run?

Trust me, I used to, until I became an Occupational Therapist and realised that it is super important within the work that we do and it’s not just an OT’s role, but rather any health professional can help you with pacing.


Pacing is designed to be used as a tool prior to exacerbation's or flares in pain, it is not intended to be reactive to increased pain states. When we push ourselves just that little bit too much (fellow clients, raise your hand with me) we enter into ‘boom-bust activity patterns’ of activity engagement.


It is completely normal and expected that you will have ‘good days’ and ‘bad days’ in relation to your pain, but when we push ourselves on days where we feel invisible, this is what often leads to us ending up in boom-bust activity patterns. If we continue to over-do it on our good days, what often happens is that we need plenty of rest and recovery on the worse days, contributing to reduced activity patterns and capacity overtime, with greater sensitisation of the nervous system overtime. So what do we do about it?


We are here to help you find the sweet spot for activity and movement.

Think about the story of Goldilocks and the three bears. Goldilocks tastes three different bowls of porridge to find the one that is just right for her – and this is what we do with pacing. We are here to help you find the ‘just right’ amount of activity or movement to help you increase your capacity.


To start we want to find your baseline – that is the level or amount of the activity that you can do without resulting in a pain flare. Remember, it is unlikely that the activity you engage with will be completely pain free, both during and after, but that’s ok and completely normal.


Pain does not always equal danger or damage. As an experiment, have a go at trying a task when you are surrounded by things that make you feel good or boosts dopamine levels, and see if your capacity changes…


Have a chat with your Evolving Pain clinician about the best way to then increase engagement in the activities that are meaningful and important to you – as that’s what we are here for.

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