The 'Boom and Bust' Cycle of Chronic Pain


We might know we should pace ourselves, but instead boom and then bust.

BOOM: I don’t feel too bad. I’m going to do the laundry, get some chores done, go shopping, run a marathon and solve world hunger.

BUST: That was too much and now I feel like death. I will have to now recover for three days.

BOOM: Those three days of recovery did me good. I feel pretty good today. I’m going to do a lot of other random things I shouldn’t be doing all at once and see what happens.

BUST: I did not expect this pain to happen again.

PACING: I feel good today but I will pace my activities because I need to conserve my energy and I know I cannot push myself beyond my limits.

We know the boom-and-bust cycle because many of us do it. On good days we may feel like we need to be extra productive to compensate for our bad days. And then we might bust into a boatload of pain, which is much worse bad days than if we paced all the time. We might just forget this happens all the damn time. Not to mention we often want to be productive on good pain days. Yet, I think it is actually better to remain consist and pace all the time to avoid significant pain flares. Not all flares, obviously, but boom-and-bust flares. I am guilty of this. I think many of us are guilty of this at some time or another.

It is much easier for me to pace when I’m not working. I am the pace master. When I am working it is easy to bust just by working alone. Work one day, all good. Step into work the next day, bust. The day after, my body is double bust. I have no recovery time. It is just a bust-a-thon. Get out of bed…bust. Dangnamit. There are ways to pace and work, but in my case, it is the exceeding pain limits that are a factor with the chronic migraines added in. I am, in fact, pacing fine in a work environment and even by reducing to part-time I was controlling the boom-and-bust cycle. But migraines are not on a boom-and-bust cycle, unfortunately, and do not respond to pacing. Sadly. They are on a trigger cycle, which is another conversation altogether. As is exceeding pain limits… that is a no-no. But for fibromyalgia pain, I think pacing and moderation are a must. In my experience, pretty much any chronic pain and chronic illness is the same. We have to manage our pain limits and limited energy.

I am not going to say “don’t do this,” because it happens. Life happens. I am going to say that pacing is vital to chronic pain management and to consider time management of your activities. My advice is to consider downtime after activities. Think of yourself like a quarter-charged smartphone; yeah you can use that app, but not for long; sure, you can do a couple of things but not too many. My point is, your daily battery life isn’t the same as everyone else’s. And if you overextend into tomorrow’s battery life too many times, then it can shock the hell out of you and force you to do very little for days.

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