Forget About "Good Days" and "Bad Days"
As someone who has fibromyalgia, I'm going to go out on a limb and assume that you have good fibro days and bad fibro days. On the bad days or during a flare, you feel tired no matter how much sleep you get and you feel like you got a hit by a bus. Am I right?
What if I told you the secret to having pain free days was to say goodbye to "good days" and "bad days" and aim for average days instead? Let me explain...
On your good days, you likely do a bunch of tasks that you've gotten behind on due to experiencing a bad fibro day. Tons of errands, chores, social events, etc. It makes sense... you have the energy today, so why not do all of the things you've been meaning to get done? WRONG. You're actually making your already sensitive nervous system (the body system in charge of your pain alarm) more sensitive.
On your bad days, you likely struggle to get through the bare minimum required. That looks different for all of us, but even if you're "functioning" at work or wherever, you'd probably love to be home in your bed with a hot pack to every part of your body. However, if you weren't active at all, you lose muscle strength and overall fitness. Guess what? That also makes fibromyalgia worse.
Okay, so what now? I want you to think of three activities that you would like to be able to do without the crash and burn. Some examples: walking the dog, vacuuming, showering, cooking. Now let's get down to business...
What is "Pacing?"
You've probably heard the term "pace yourself" long before your fibromyalgia diagnosis. Activity pacing is a strategy to build up the tolerance to do a specific task without having to rest for an extended period of time afterward ("paying for it later"). It's the main strategy I used to go from spending my life in bed to hiking 12+ miles in one day without being in a flare for weeks afterward.
Pacing Like a Pro
Step 1: Establish your baseline for a specific activity. To do this, figure out how long you can do the specific activity or task on (1) a good day, (2) a bad day, and (3) an average day. Average those three and take off 20%. That's your baseline.
Step 2: Do that baseline daily. No. Matter. What. And if you're having a good day, stick to your baseline (don't do more than the plan, Stan!).
Step 3: If you can do that activity daily for one week WITHOUT a flare, increase the length of time doing that activity by 15%.
Step 4: Repeat Step 3 until you've reached your goal!
Example: Let's say your goal is to walk 30 minutes without stopping.
With this concept, the new baseline is 6.5 minutes of walking without stopping and the plan is to walk 6.5 minutes every day. If you can walk for 6.5 minutes without a significant increase in fibromyalgia symptoms for one week, increase this time by 15%. So for week two, you would be walking 7.5 minutes.
In this example, if you consistently increased the baseline by 15% every week, you would reach your goal in 12 weeks! More importantly, you'd be avoiding the crash and burn patterns that make your nervous system more sensitive.
Now It's Your Turn
We've created a free step-by-step guide so you can create your own pacing plan!
Andrews, N. E., Strong, J., & Meredith, P. J. (2012). Activity pacing, avoidance, endurance, and associations with patient functioning in chronic pain: a systematic review and meta-analysis. Archives of physical medicine and rehabilitation, 93(11), 2109–2121.e7.
Birkholtz, M., Aylwin, L., & Harman, R. M. (2004). Activity pacing in chronic pain management: One aim, but which method? Part One: Introduction and literature review. British Journal of Occupational Therapy, 67(10), 447–452. https://doi.org/10.1177/030802260406701005
Kengen Traska, T., Rutledge, D. N., Mouttapa, M., Weiss, J., & Aquino, J. (2012). Strategies used for managing symptoms by women with fibromyalgia. Journal of Clinical Nursing, 21(5‐6), 626-635. doi:10.1111/j.1365-2702.2010.03501.x
Fibromyalgia is not a "one size fits all" diagnosis. What works for some doesn't work for others. The information provided is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. Should you have any health-related questions, please consult your physician or other health care provider promptly.
Teresa & Hannah are fellow fibromyalgia warriors. Teresa is a certified dietary manager and wellness coach. Hannah is an occupational therapist. Together, we're a mother-daughter duo on a mission to empower others to fight against fibro.