A clinical program of Energize Occupational Therapy Services
Saying “Pace Yourself” Is
Not Always Enough
People living with chronic pain are frequently advised to pace themselves, take breaks and stop before they overdo an activity. This can be useful advice—but it assumes that the person can recognize what is happening inside their body early enough to respond.
Many people also cannot simply stop whenever symptoms begin. They still need to work, care for themselves, manage their homes, support family members and participate in activities that make life meaningful. Effective pacing therefore needs to involve more than scheduled breaks or doing less.
Pacing Starts With Noticing
Some people with chronic pain or fatigue do not notice increasing tension, effort, fatigue or pain until their symptoms have already become severe. Others notice a sensation but have difficulty interpreting what it means or deciding how to respond.
Early warning signs do not always feel like pain. They may appear as changes in movement, posture, breathing, concentration or effort. For example, someone may begin shifting their weight shortly before their pain rises sharply. Weight shifting is common and is not inherently a warning sign. For that particular person, however, its timing may provide useful information that their symptoms are beginning to escalate.
The goal is not to teach that any one sensation or movement is a problem. It is to help each person recognize which signals are meaningful within their own pattern.
Developing Interoceptive Awareness
Interoception is the ability to notice, distinguish and understand signals arising from within the body. It helps connect three important steps: noticing a sensation, interpreting what it may mean and deciding whether a response is needed.
In my chronic pain-focused practice, I frequently help clients learn to:
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recognize earlier changes in tension, effort, pain or fatigue;
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distinguish sensations that initially feel similar;
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determine whether a sensation reflects ordinary effort, increasing symptoms or something else;
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identify patterns across activities, environments and times of day;
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predict how their body may respond to an activity; and
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decide when and how to respond before symptoms become overwhelming.
Simply telling someone to “listen to your body” may not be enough when the signals are unclear or their meaning has not yet been learned.
Interoception-focused work may involve comparing sensations across activities and positions, noticing what changes before symptoms increase, bringing awareness to different body states, using pain tracking to identify patterns and practising brief check-ins during everyday activities. These methods are directed by the occupational therapist.
Turning Awareness Into Action
Once a person can more clearly notice and interpret their signals, pacing becomes more individualized. Together, we may explore when to:
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reduce physical or cognitive effort;
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change position or increase physical support;
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modify a task or environment;
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switch to a lighter activity;
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use relaxation or nervous-system regulation strategies;
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stop and recover more fully; or
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gradually increase participation.
This is also where pacing connects with my concepts of "Active-Working" and "Working-Recovery". Instead of choosing only between pushing through and stopping completely, clients learn ways to change how they are working so their body has an opportunity to recover while they continue participating.
Pacing Is Not Avoiding Life
The goal is not to avoid every increase in pain or make every day symptom-free. Pain is real, and it deserves to be respected—but avoiding all activity can also make life boring.
Sometimes a meaningful event or activity (like a wedding) is worth additional effort and worth a possible symptom flare. Pacing can include making that choice intentionally, preparing for the possible consequences and planning the recovery that may be needed afterwards.
Effective pacing is not a universal schedule. It is the ability to understand your own patterns, respond with greater choice and use your energy in ways that support the life you want to live.
