How fibromyalgia pain can become self-reinforcing
How small, consistent steps can reverse the pain cycle
A two-page printable worksheet to help you find your activity baseline, plan your daily routine, track your progress, and set weekly goals. Includes a visual guide to the boom-and-bust pattern and how pacing works.
Download Worksheet (PDF)Many people with persistent pain fall into a 'boom and bust' pattern - doing too much on good days, then crashing and being unable to do anything for days afterwards. This roller-coaster makes pain worse over time and makes it harder to plan or enjoy your life.
Pacing is a strategy for breaking this cycle. Instead of pushing through until pain stops you, you do a planned, sustainable amount of activity - then take a planned rest before the pain flares up. The idea is to find a baseline you can manage consistently, even on bad days, and then gradually build up from there.
Download the worksheet above to start planning your paced routine. Print multiple copies so you can use it week by week.
A one-page visual guide explaining how persistent pain works, why your nervous system becomes sensitised, and what you can do about it. Print-friendly PDF format.
Download PDFPain is one of your body's most important protective systems. When you touch something hot or twist an ankle, pain signals travel from the injured area through your nerves to your spinal cord and up to your brain. Your brain then processes these signals and decides whether you need protecting. The result is the experience of pain - and it makes you pull your hand away or rest your ankle.
But here's the key insight from modern pain science: pain is produced by the brain, not by the body part that hurts. Your brain takes information from your nerves, but also factors in your memories, emotions, beliefs, stress levels, sleep quality, and the context of the situation. All of this gets weighed up before your brain decides how much pain - if any - to produce.
This is why two people with the same injury can experience very different levels of pain. And it's why pain can persist long after tissues have healed.
With persistent pain conditions like fibromyalgia, something changes in the nervous system. The nerves become more excitable, and the brain starts to interpret normal signals - such as gentle touch, movement, or even temperature changes - as threatening. This process is called central sensitisation. Think of it like a volume dial that's been turned up too high: ordinary sensations get amplified into pain.
This doesn't mean the pain isn't real - it absolutely is. It means that the pain system itself has changed, and the pain is being driven more by the nervous system than by ongoing tissue damage.
Several factors can increase pain sensitivity: poor sleep, stress and anxiety, low mood, fear of movement, social isolation, and a lack of understanding about what's happening. When your brain perceives more threat - from any source - it's more likely to produce pain.
Understanding how pain works is itself therapeutic - research shows that pain education can reduce pain intensity and improve function. Alongside this, gentle graded movement, good sleep habits, stress management, pacing your activities, and building social connection all help retrain your nervous system. Recovery isn't about finding a single cure - it's about gradually turning down the sensitivity of your pain system through consistent, small changes.
This is the foundation of the self-care approach used in my fibromyalgia programme.
Short video explanations on how pain works, what causes chronic pain, and what you can do to manage it.