Pacing With Fibromyalgia and Chronic Fatigue Syndrome

When living with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS), pacing is key to managing your symptoms. With the busy lives most of us lead, that's easier said than done! Still, with some effort, you can learn to pace yourself. And you'll be glad you did.

Why Pacing Is Important

FMS and ME/CFS can really sap your energy. When your energy is low, everything you do takes a greater percentage of the whole. As you've probably learned the hard way, when you overdo it, you pay a steep price in heightened symptoms.

Many of us push ourselves on good days, trying to catch up on everything we can't do the rest of the time. In one day, we'll do multiple loads of laundry, clean the kitchen, weed the garden, and go to the grocery store. When symptoms start to kick up, some of us push harder, feeling like we have to get everything done before we're in too much pain to keep going.

But the only thing that does is make us worse. What good is one productive day when it leads to three (or ten) on the couch? Once you realize that the push-crash cycle isn't working, you're left asking, "How can I get stuff done without making myself worse?"

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

How to Pace Yourself

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. Below is a closer look at each strategy.

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 you handle in a day (or in one stretch)?
• How much mental exertion can you handle in a day (or in one stretch)?
• What activities impact you most?
• At what time of day do you have the most energy?
• What symptoms are "early warning signs" that you've neared your limit?

Once you know these answers, you're ready to apply pacing techniques to your life.

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 in between. Set a clock so you don't get caught up in it and go for too long. See how you feel after a couple of days, then adjust times until you've found the right balance.

Scheduled Rest

Scheduled rest periods are more than the short breaks you take between bursts of activity. Instead, it's time built into your day when you can take a nap or get some real rest. Again, the length of time is something you have to define for yourself. Lying 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, pay bills, read, or make your grocery list. Your mind needs rest just like your body. Try sleeping, lying quietly, meditating, or taking a hot bath.

Routines

Routines can really save you, especially if you have a lot of brain fog. If you establish and stick to a routine as much as possible, it helps prevent problems like pulling weeds all morning and then realizing you need to go grocery shopping.

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. Look at your average energy and under-schedule each day based on that. If you finish up and still have energy, you can work ahead. When you have a few down days, catch up over the course of several days, re-prioritizing to take care of the most important things first.

Prioritizing

Priorities are crucial to pacing. Try to have a clear picture of what absolutely must get done in a day, and focus your 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 into 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 limitations of your illness can often help with this by adjusting other people's expectations about what you're able to do.

You may also need to educate people in your life about your illness.

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.)

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.