Hi there- I don’t have PMR (I am a caregiver for my father who has PMR), but I have a different inflammatory arthritis, and that cycle happens to both of us. I think fatigue is part of most chronic pain conditions, even when we’re feeling well. Our PTs and care team recommend pacing, so basically trying not to overdo it when we feel good—of course way more easier said than done! The idea is to do what you can when you feel good, but try to leave some energy in the tank so that it doesn’t take so long to recover. The concept of “pacing” always went in one ear and out the other for me, until an OT used a green/yellow/red light analogy. She suggested to try to sandwich physically or cognitively demanding tasks (yellow or red light) with more restorative activities (green light). Our bodies are doing a lot of work for us that can’t be seen fighting off the inflammation and building up endurance, and once I started attempting to look at it that way, I suppose I can see why I get so tired so quickly… This isn’t to say that it isn’t insanely frustrating though! Good luck to you; you’re not alone.