What are the “Four Ps,” and how can they help me with fatigue? 

Meet the “Four Ps,” the best techniques to help you cope with fatigue (often considered a silent symptom of arthritis). Here’s how to do it.  

P #1:  Priorities 

Keep a list all your activities, both work and leisure, for one week. Then, arrange the activities in order of importance in your life (in other words, your priorities). You may want to group the activities into categories like Work, Home and Play. Now take a look at your list: Are the activities concentrated into a few days or spread out during the week? Is there something in particular that causes pain or fatigue? Do you schedule your top priorities for the time of day you feel the best? Are you taking breaks during the day? Then, think about how to simplify. What can you skip, do differently or delegate? 

P #2: Pacing 

There are lots of ways to break up your daily activities so you’re not jamming difficult tasks together. How about: 

  • Following the “Two Hour Pain Rule”: If you feel pain for more than two hours after you did a particular activity, that’s a sign you overdid it 
  • Switching between sitting, standing and walking 
  • Taking regular breaks for a few minutes 
  • Walking at a moderate pace (rather than fast or slow) 
  • Alternating activities, so you aren’t always putting strain on one muscle group 

P #3: Planning 

Planning is a great secret weapon, and it requires being honest with yourself about your energy levels. If, say, mornings are usually good, that’s when you schedule your more demanding activities (just don’t overdo it). Something big coming up? Book a rest before and after. Alternate the easy stuff with the demanding stuff. See if flextime is an option at work.  

This “P” can also include “problem solving.” Think about what you want to do, and if there’s a better way to do it with a device like a brace or splint, a different route to get from A to B, or a way to move your body that’s more efficient. 

P #4: Posture 

Yes, posture! Correct posture distributes weight over the bigger muscle groups, helping you conserve your energy. Some ideas: 

  • Do a posture check: ears over shoulders, chin tucked in, shoulders down and back, tummy in, seat tucked under, knees unlocked 
  • Use your strongest and largest joints whenever you can 
  • When you’re lying down, use a cervical pillow or roll to support your neck 
  • Store items you use the most between waist and shoulder height  
  • Mix it up between sitting and standing  
  • Check in with an occupational therapist to find out the best height for counters and other work spaces  
  • When driving, sit close to the wheel with knees bent, use a supportive pillow at your lower back, and stop and walk often on long trips  
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