Pacing with Fibromyalgia and Chronic Fatigue Syndrome

When living with fibromyalgia and chronic fatigue syndrome, pacing is key to managing your symptoms. That's easier said than done with the busy lives most of us lead, but with some effort, you can learn to pace yourself.


Why is Pacing Important with Fibromyalgia & Chronic Fatigue Syndrome?

Fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS) can really sap your energy. When your energy is low, each activity takes a greater percentage of the whole. As you've probably learned the hard way, when you overdo it, you pay a steep price.

I used to really push myself on good days, trying to catch up on everything. In one day, I'd try to do multiple loads of laundry, clean the kitchen, weed the garden and go to the grocery store. When my symptoms would start, I'd push myself harder, feeling like I had to get everything done before I felt so bad I couldn't do anything.

It wasn't long before I realized that only caused setbacks: one productive day would lead to three on the couch. Then I asked, How can I get everything done without making myself crash?

The answer is pacing. It takes practice, but after awhile, it gets to be second nature.


How Do I Pace Myself?

A lot of pacing strategies can help you live better with your condition. They include:
  • Knowing your body
  • Short activity periods
  • Scheduled rest
  • Routines
  • Prioritizing
  • Switching tasks
Don't feel like you need to use them all — experiment and see what works for you.


Pacing 101: Knowing Your Body

To be successful at pacing, you have to pay attention to your body and know your limits. It can help to keep a journal or symptom log. Your goal is to answer these questions:
  • How much physical activity can I handle in a day or at a time?
  • How much mental exertion can I handle in a day or at a time?
  • What activities impact me most?
  • At what time of day do I have the most energy?
  • What symptoms are "early warning signs" that I've neared my limit?
Once you know these answers, you're ready to apply pacing techniques to your life.


Pacing 101: Short Activity Periods

We're sprinters, not marathon runners. If you have a big job, don't try to plow through it for hours. Work for a short time, rest for a while, then work for another short period.

The amount of time you work and rest depends on your capacity for activity. Start with shorter periods than you think you can handle, and rest for at least 15 minutes it between. See how you feel after a couple of days, then adjust times until you've found the right balance.


Pacing 101: Scheduled Rest

Scheduled rest periods are more than the short breaks you take between bursts of activity. Instead, it's time built in to your day when you can take a nap or get some rest. Again, the length of time is something you have to define for yourself. Laying down for half an hour may give you a nice boost, or you may need a two-hour nap.

Your scheduled rest period is not the time to check e-mail, watch TV, read or make your grocery list. Your mind needs rest just like your body. Try sleeping, laying quietly, meditating or possibly taking a hot bath.


Pacing 101: Routines

Routines can really save you, especially if you have a lot of brain fog. I have a weekly schedule to keep me on track both in my job and with household tasks. If I stick to it, I know I won't end up needing to go shopping on the same day I pull weeds or running errands on days when I need to be home writing.

The biggest barrier to routines is that our conditions are unpredictable. We rarely know when we'll have bad days or when a good day will take a turn for the worse without warning.

To deal with this unpredictability, build in flexibility. I look at my average energy and under-schedule each day based on that. If I finish up and still have energy, I work ahead. If I have a few days when I can't get anything done, I catch up over the course of several days, reprioritizing to take care of the most important things first.


Pacing 101: Prioritizing

Priorities are crucial to pacing. I try to have a clear picture of what absolutely must get done in a day, and I focus my energy there. If less important things need to wait as a result, then that's just how it is.

If you find yourself feeling as if too many things have to get done in one day, make a list and then break your list in to three parts: needs, wants and shoulds. "Needs" are top priority, have-to-get-done-right-now-or-there-will-be-consequences things. "Wants" are things that you'd really like to do IF you have the energy. "Shoulds" are things you feel like you ought to do to please someone else or because other people would do them (such as, "I should cook a big, elaborate meal on Sundays, because my mom always did.") Take care of your "needs" first, then move on to the "wants" (again, IF you have the energy). If you can't get to the "shoulds," so be it.

The "shoulds" can be a big source of guilt, because by not doing them, you may upset or disappoint someone. Good communication about the limits of your illness can often help with this by adjusting other people's expectations about what you're able to do. You may need to educate people in your life about your illness. Here are some articles to help you:


Pacing 101: Switching Tasks

Instead of doing one thing for a long time, try to change the type of activity frequently. If you do one physical activity for too long, it can tire out the muscles you're using, which may lead to pain and fatigue. This goes for both physical and mental activities.

For example, say you need to wash dishes, fold laundry, pay bills and return some e-mails. Don't do them in that order! Instead, wash dishes, pay bills, fold the laundry, then work on e-mail. By alternating physical and mental activities, you give your brain and muscles the rest they need. (And don't forget that you may need rest periods in between each activity as well!)


Pacing: It's An On-Going Process!

Pacing takes some effort and self-discipline on your part. Once you see the difference it can make, however, you'll find that it's easier to pace yourself than to deal with the consequences of NOT doing it.