Eileen Hopkins
Professional Psychotherapist, Life Coach & Public Speaker
Chronic migraine is a highly disabling neurological condition that can have a huge effect on everyday life, preventing patients from being able to do day-to-day tasks.
Chronic migraine is defined as a headache present 15+ days per month, which represents the majority of patients attending the Headache Clinic. The mental health implications can be severe with chronic migraine, but finding a way to manage your condition is key. One way to do this is ‘pacing.’
Understanding pain
Pain is a hugely emotional experience as well as a physical sensation. Many thoughts can increase our pain experiences such as anger, frustration, guilt, despair, anxiety and hopelessness.
Some people with ongoing pain tend to avoid physical activity altogether, whereas others may push through the pain and overdo it. This can result in a pain flare-up. By self-managing your pain, the focus is not on your body, it is on ‘you’ instead.
Pain is a hugely emotional experience
as well as a physical sensation.
What is pacing?
‘Pacing’ self-management means adapting your situation to live a more fulfilled life despite pain. Self-management is not a replacement for medication, though many find they can reduce their medication.
Pacing involves commencing a daily activity routine, given your current level of fitness and pain. That is easily achievable by doing a little bit, but more often. This results in improvements to help you to become more active and healthy. The idea is to break the brain’s association between a particular movement and the fear that it results in pain.
How to start pacing
• Firstly, talk to your doctor to explore ways to get moving again.
• Start slow; a small amount of regular activity is better than overdoing it.
• Gradually increase activity daily; increase by 10% weekly, if comfortable for you.
• Pace activity over a realistic timeframe.
• Stick to your chosen timeframe no matter how good you feel.
• Add in a rest period.
• Record progress in a diary.
• Keep a pain-free diary, to train your brain to expect less pain.
Consistency is key, and this doesn’t mean that you won’t have bad days, but it’s about looking for that shimmer of light on darker days.
Information provided by Esther Tomkins Clinical Nurse Specialist, Headache Clinic, Beaumont Hospital. The Migraine Association of Ireland run three free courses per year on self-management for chronic migraine. For more information, contact us at [email protected]