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For more information, please see our chapters below: which cover, Fatigue and pacing, Sleep, Goal Setting and Exercise.

Fatigue and Pacing

pain cycle

Fatigue is a feeling of exhaustion that can affect you physically and psychologically. These symptoms can last short or long periods having effects on your normal daily routine such as getting washed and dressed to difficulties continuing to work. Fatigue can also make you feel emotionally tired affecting your mood and motivation.

Do others around you know how you feel? Helping our friends, family and work colleagues understand why we feel fatigued can really help. The more they can understand what causes us to feel fatigued, the more they are able to help. It's not about avoiding the task or activity, it's about doing it at our own pace. 

Hover over the boxes to find out more.


Can you spread tasks out throughout the week?


Is the task urgent or can it be left to another day or all together?


Can you spread out the task throughout the day/week?


Can you ask others to help complete harder tasks?



Are you completing the task in the most efficient way? Could it be done another way?

Happy Woman

"Pacing is about taking a break before I need it throughout the day. Only carrying out short periods of activity and taking scheduled rests. It really helps when I judge when to stop an activity based on TIME and not on PAIN. Pacing helps give me back some control"

Prioritising and planning can be a helpful way to manage pain. Make a list of things that you would like to do but remember to be flexible. It is a good way to set yourself a starting point. i.e what are the things that NEED to be done, and what things could perhaps be done another day. For example, do you really need to clean the entire house today? Or could some of it be done tomorrow? Or if you need to do a food shop today, do you really need to do get 2 weeks worth of food in one go?

Sleeping Better.


It can be really challenging to get good quality sleep. However, we know that the amount of sleep we are able to achieve can directly affect our perception of pain. Quality of sleep is an important factor.
In an experiment, healthy, pain free  volunteers were woken during each period of deep sleep. Over time, as their sleep was disturbed a number of them developed the typical signs and symptoms of Fibromyalgia. The quality of sleep we are able to achieve, can have a direct impact on our sensitivity to pain.

Woman Sleeping

A bad nights sleep can make us feel irritable, frustrated and can actually increase how much pain we feel. This in turn can put a strain on our relationships which, can often add to our frustrations. 



For Fibromyalgia, your Rheumatologist may encourage you to take medication to help you sleep better. It is important to talk about your medication with your Doctor. If you don't feel it's working for you, there may be other options you can try. The medication that works for one person, may be different for another. 

The environment we surround ourselves in can have both a positive and negative affect on our sleep. Going to bed in a comfortable, quiet and dark room can have a positive effect.

Giving our brain stimulation can have a negative effect on helping us to relax and fall asleep. E.g. caffeine, smoking and alcohol all have the effect of ‘waking up’ the brain and can therefore reverse our attempt to fall asleep. The same can be said for lights form outside, mobile phones or the TV.

If we able to get into a pattern with our sleep, this can help to teach our body when we should be sleeping. E.g regularly going to bed at the same time each night. It may also be beneficial to have a ‘wind down’ routine e.g taking a bath or reading a book.

The Sleep Advisory Panel




For healthy functioning of our body, exercise is essential. It plays an important role in helping the body regulate many of its functions, including heart rate, blood pressure, and cholesterol. A lack of exercise is also know to have a negative effect on our mood, our sleep and can also lead to weight gain. Even our memory can be affected. Getting into a regular form of exercise that you both enjoy and can keep up, can be an important tool in helping you sleep better and reduce pain.

Medication can be a helpful way to allow us to get back into a regular sleep cycle and ensure we find a ‘deep sleep’. Your Doctor may have prescribed you drugs such as Amitriptyline, Gabapentin or Pregabalin. Other types of pain medication may also have a drowsy side effect. You should consult your Doctor or Pharmacist if you are unsure if you are on the correct medication.


The Sleep Advisory Panel


Goal Setting

Goal setting

Goal setting is like pacing, you can use it to gradually build up the activities you want to do. Set yourself simple, realistic goals or action plans. Decide what you want to do more of. Perhaps you could set yourself a simple hourly, daily or weekly action plan.


Let's try plan out your next goal. The goal should be specific, measurable, achievable, realistic and time directed.

It should be your own goal – don’t let someone else pick it for you.

Try not to be too ambitious to start with, pick something important to you, but not impossible.

On a Walk

Did you



You are 42% more likely to achieve a goal if you write it down and talk to someone else about it.

Review your progress and re-think some of your methods if they are not working.

Remember each small step is an achievement in itself, and that lots of small steps can help to take one larger step towards a more active life.

Friends Talking Outside
Walking Club

Instead of:

"I want to be able to walk more"

“In 4 week’s time, I want to be able to walk the 1 mile to the shops and back"


Forest Trees

Find out more here


Evidence shows that strengthening exercises can reduce pain and elevate mood. Other exercise can also be incorporated into your program including Yoga, Tai Chi and Pilates. These should be used in combination with the stretches and exercises that get you out of breath.Attending an instructor lead class such as Pilates or Yoga, can be a good way to get started if you are unsure about what you should be doing. Harrogate Council also run exercise groups for people with medical conditions – find out more here

Pain and fatigue is a common symptom of fibromyalgia. Often when we have pain and feel tired, the last thing we want to do is start to exercise. However, exercise is actually one of the best things we can do to help manage our pain. It can help break down that pain cycle. 

Finding the right sort of exercise is an important step to management and can be a great way to increase social interaction and help us feel good about ourselves again.

Find out more here

Aerobic Exercise

Aerobic simply means that your heart beats faster and you are a little short of breath when you exercise. Aerobic exercise improves overall well-being and physical function. Increasing daily activities can be aerobic. i.e. stair climbing and walking. Swimming & hydrotherapy are also particularly recommended.

How will I feel after exercise?

  • Moving your body may be difficult at first, but over time you should notice that activity gets easier.

  • Build up your exercise at a rate you can cope with, pace yourself and be patient.

  • Pain and tiredness may become worse at first as you start to exercise muscles that haven’t been used for a while – stick with it and things will improve.

  • Try and do a little exercise each day so that you build up your muscle strength and stamina levels.

  • It is possible that you may experience an episode of increased pain, a ‘flare-up’, following exercise. Don't worry, this is normal and will get better with time and consistency.

  • Continue to take your medication as prescribed.

  • If you are unable to exercise, rest then re-start slowly as you are able.

  • Set yourself realistic goals.

  • Try to think positively – negative thoughts can make things worse.