Toward a Deeper Understanding of Fibromyalgia Fatigue

Toward a Deeper Understanding of Fibromyalgia Fatigue

If there was just one thing I would like people to understand about fibromyalgia, it would be the profound fatigue that defines us. Sure, everyone gets tired. Everyone has a limit to what they can accomplish in a day. The thing that’s unique to fibromyalgia is the degree of our fatigue and the fact that resting doesn’t restore us. 

Here’s what I mean: Typical people can do a physical activity until they’re tired, rest for a while, then get up and do some more. Not us. We can do a physical activity until we’re tired. However, no matter how long we rest, we just can’t muster the strength to get up and do any more.

When our energy tanks for the day, we’re done. Kaput! I’ve had to call my husband to come pick up me many times after an enjoyable walk, a rest on a bench, and an inability to make it home. 

In order to live our lives to the fullest, there are two important factors to consider about fatigue. The first involves knowing our limits. The second involves pacing.

Of course, there’s a difference between knowing our limits and respecting them. Disappointing as it might be, we may need to modify or even opt out of a particular activity. I, for one, rarely hesitate to do that anymore. The consequences of overactivity, such as increased pain and fatigue for at least the next day or two, are just not worth it to me.

Knowing our limits is not as easy as it sounds, however. Those limits are constantly in flux. During, and shortly after, a period of increased symptom severity, our bodies may be greatly deconditioned. Those are the times when we are most limited.

However, if we’ve recently experienced fewer symptoms, we may have regularly stretched and exercised. In that case, we may be much less limited. At those times, people we know often have difficulty believing the severity of our illness.

The second thing to consider is pacing. In many ways, this is even more challenging than knowing our limits. For someone with fibromyalgia, pacing means resting before becoming tired. Knowing that it’s time to rest and actually doing it requires a great degree of self-discipline.

The challenge is that there are always things that need to be done. These things can only be done when you have energy. Because that energy is so precious, there’s a natural urge to finish them so that you can move on to the things you’d rather be doing.

Therein lies the problem. By the time your “must-do’s” are done, you’ve no energy left for the “want-to-do’s.” It’s frustrating, for sure.

One technique I’ve adopted to improve my pacing and avoid increasing my fatigue is to keep two lists. One includes all the things I need to do that require physical activity. That list currently includes declaring war on the dust bunnies under the furniture and removing the “Danger Zone” warning on my refrigerator. Each of these tasks will require some serious pacing.

The second list includes sedentary activities that can be done while resting. That list includes bills to pay, appointments to schedule, and financial issues to resolve. It does not include playing Words with Friends or reading my recent library book. Those are things I’d prefer to be doing if it weren’t for the necessary items on the two previously mentioned lists.

The goal, of course, is to find the right balance of each type of activity. I wish there were a secret formula for how much of each to do. But my abilities are different from yours. And they vary from day to day. The best we can do is to listen to our bodies — and forgive ourselves when we don’t always heed what they tell us.


Note: Fibromyalgia News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Fibromyalgia News Today, or its parent company, BioNews, and are intended to spark discussion about issues pertaining to fibromyalgia.


  1. Shahem Zenni says:

    When we leave comments does the public see them? My comment is on the other article about hypnosis and that they only found 3 men for the study (I still believe there are way more men than we know about) as men are notorious for not “talking about” or having checked out medical issues (especially chronic pain like Fibro) there may still be a stigma that men aren’t strong if they complain about pain. Pain is pain in humans so to say this is strictly a woman’s problem?

  2. Linda M Villegas MS FNP says:

    First of all, most men tend to deny that they have pain, unless it is severe or immobilizing…They even have great difficulty describing what and where they experience problems with their body or emotional feelings. This is what I have experienced in my practice….much less would they surrender to hypnosis easily..if ever.
    Women, in contrast are generally aware or on top of pain they experience, and are keen to explore it and get treatment if needed early on. It’s a shame that men in general, are not as well acquainted their bodies or their sensory and emotional responses to everyday life stressors. Mostly, albeit more sensitized to fear of the unknown….not necessarily “stigma”. This presents a double whammy. Potential medical problems are not examined or ruled out. Men are more avoidant to exploring pain and known to die of a “seemingly” unheralded sudden heart attack than women. Hypnosis is an easy method to release bodily, emotional and even unconscious pain….at least temporarily. Most people can learn this, even self hypnosis. I use this in my FM & CME treatment. Along with graded exercise, PACING and consistent dietary avoidance of known offending foods and other environmental stressors, and this includes some people I don’t have to deal with. I need nothing more than acetaminophen and rest.

  3. Janet Kelly says:

    I am greatly fatigued. So much so that exercising is a thing of the past. Yes, I know exercise helps this illness. I am in so much pain though that I can barely move and it doesn’t get better with time or amount of time I exercise. I’m 75 years old and I feel like I am just waiting to die. I’d never take my own life but I’m getting very frustrated that after 34 years with FMS I can find no relief. I take pain meds and have difficulty getting them. The so-called opioid crisis was not intended for those in chronic pain but we are the ones who have suffered the price of not being able to have enough relief from the pain of FMS. I’m so very tired and need help but cannot get it.

  4. Cindy smith says:

    This is so true 25 yrs ago the pain was so bad I reported it to my Doctor and he sent me to pain management and finally I found relief so time goes on and the crap happens with opioids and then the doctors started giving us fm a difficult time. It got so bad they were causing more harm with the anguish of pressure and shots to my spine , the shots were very painful and would put me in bed for a week or two from pain, I told them what was going on and they stopped seeing me, people can’t have a clue of the feelings you go through the with fb , the doctors treat us like we enjoy being in pain for pills ,. Shame on you .!!!!

  5. Jo-Ann O'Neil says:

    I am 71 yoa, and I have fb + other physical and medical problems. I really don’t know how long I’ve had this evil. All I know is I’ve been in this pain for a long time. My present pc had agreed to put me on Cymbalta. It helps. When I try to talk to her about my total pain, her answer is NO! I’m a Veteran, and we’re supposed to be receiving the best of care. As for me, I disagree. I give them an F— score. I live in pain and I cry in silence. 💔😢

  6. I am 70 and was diagnosed with fibromyalgia at age 40, along with IBS and aura migraines. I am currently on Cymbalta which helps manage the bouts of depression from living with daily pain and fatigue. I now use a topical 800 mg CBD cream on pain areas which does help, and it also helps my arthritis. I was also deficient in Vitamin D3, until I changed to the liquid form and that has also helped my fibro. Fighting the mental and emotional fatigue is a constant battle, and some days I just veg on my recliner with my two fur babies. When I hit menopause, my hormones went haywire along with my weight and I am still battling those changes. Exercise is a double edged sword. Prior to COVID I did a mild exercise routine at the fitness center, and hope to return post COVID. Pacing myself is hard, because on good days I do too much to make up for the bad days!

Leave a Comment