Pacing for Chronic Pain Management

My interest in pacing for chronic pain management came from meeting a marathon man with a problem.

I can’t run for more than 15 minutes before my back becomes so painful I have to stop” he said.

That’s what the fit, somewhat unhappy 54 year old man was telling me was his problem. He had always been a runner since he was a young man and had competed in several marathons. He still ran twenty miles in one session at least once a week.

At least he used to.

He’d developed gradually increasing back pain about three months previously, and this had started to cut into his running and become a nuisance. Every time he went out running he felt fine until he got to 15 minutes, then BANG, his back pain worsened significantly, forcing him to stop.

He’d been repeating this unrewarding pattern regularly for the last month and had got nowhere. His back was just as bad and his running had not improved. He was getting fed up with the restrictions and had started to ask himself questions such as whether he should give up running.

Now, I was a physiotherapist of 22 years experience and was used to looking for technical reasons for a person’s pain and doing technical manoeuvres to them.

Except I didn’t.

I explained the reasons why he was having his pain and how his behaviour was maintaining the problem. I suggested he changed his running technique to take account of pacing to control his pain.

It worked. Three months later he came back to report on this progress. He had taken a month to get back to twenty mile runs but he had done it. Then he fell down a bank in a garden at night at a party! This made his back worse, but he had moved up to twenty miles again over the next four weeks.

So he had done it twice in three months!

To be honest it wasn’t just this man that started my interest in pacing for chronic pain management. But it was his very clear story that made me think about writing something for everyone with pain problems. I was sure the principles would apply to many people and in many different situations. I felt that this knowledge could be useful.

I’ll be covering pacing in much more detail in future.

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