RECOMMENDED LIFESTYLE CHANGES FOR PERSONS WITH FIBROMYALGIA

PACING

WHAT IS PACING?

Pacing is a researched practical approach used to manage pain and fatigue when managing a chronic illness. Pacing involves breaking down activities into smaller bits. By regulating your level of activity, you will have better success in accomplishing your goals. Pacing is important in pain management because by doing small bits of activity often, you continue to stay active, without pushing your body past its limits. Start low and go slow!
By implementing pacing into your life, you can avoid pain flares while improving your tolerance to activity. As a result, you are able to do more of what brings you joy and you will feel as though you have more control over your life. When you have a chronic illness like fibromyalgia, it is necessary to find ways to improve your quality of life.
Pacing is a technique that may require some advanced planning. The goal in using this strategy is to very slowly increase your level of activity over time. It is also important to be using your energy wisely so you are able to be part of the activities that you find meaningful. 
Research shows that avoiding activity or doing too much activity are associated with poor outcomes.

HOW DO I PACE?

In order to learn to pace successfully and understand what your baseline is, the following steps are a very useful guideline:
  1. Set a goal and a baseline. Determine the amount of time you are able to work on an activity or exercise without a pain or energy flare. Take 3 measures over 3 days. Calculate the average of these measures. Reduce this number by 20% to allow yourself a small buffer. Your final number is your baseline. You will use this baseline number for your particular activity during week one. Repeat these steps for all other activities. Record your activities and symptoms for week one using a chart or journal. This will give you a reference to use to monitor your progress.
  2. Repeat the task daily.  Using the baseline number you calculated in the first step, do the activity daily for the first week. Some examples of activities you may want to set a baseline for are doing dishes, going for a walk, or completing repetitions of a physiotherapy exercise. Do not do more of your baseline on a  good day. If you do more than your baseline, there is a very good chance you will experience a set-back or flare.
  3. Increase your baseline number by 10% each week. Slowly increase your baseline (time, distance, number of repetitions, etc.) by the indicated percentage each week, provided you do not experience a flare as a result of your activity level the week prior. If you do experience a flare, do not try to set an increase. Go back to a level that you are able to cope with and pace yourself up again.
  4. Use SMART goals to increase your activity levels
            S - Sustainable
            - Meaningful
            - Achievable
            - Realistic
            - Timed
            Write down your goals to keep yourself on track and to serve as a reminder of what you value in your life. 
Now that you have a guideline on how to pace, hopefully you will begin to find a significant improvement in your pain and fatigue levels. Like anything new you are trying, remember to be persistent, yet patient. 
Here are a few other pointers you are likely to find beneficial:
  • Take planned breaks regularly, even on days you are feeling well.
  • Adjust your body’s positioning when you are working on a task. 
  • Plan short rests before and after demanding activities. Remember that anything demanding counts as physically or mentally strenuous.
  • Practice relaxation, daily walks, and gentle stretching to help control pain.

Resource: painhealth.csse.uwa.edu.au (Department of Health. Government of Western Australia)