Energy Envelope Theory

The Energy Envelope Theory is a self-management tool to reduce symptom severity and the frequency of relapses. This theory suggests that because variations in day-to-day energy levels are often unpredictable in people with ME/CFS, they are to assess their perceived energy levels on a daily basis (or in smaller time increments, as needed) and use that level to gauge their energy expenditure for the day. It encourages people with ME/CFS to accept their daily energy limitations and not exceed or fight them.

Some practitioners of the Energy Envelope Theory take the concept further by recommending that people with ME/CFS do less than their perceived energy would allow in order to have energy left over for recovery.

Under the Energy Envelope Theory, treatment programs that recommend a steady increase in daily activity are discouraged because the person with ME/CFS may exceed the amount of energy available for that day, thereby initiating post-exertional malaise or an increase in symptoms. Those that stay within their daily "envelope" of energy, not only have fewer symptoms but often recover to a higher functioning level than those who don't.

The concept of staying within one's "energy envelope" is a similar pacing technique to the spoon theory.

Patient experiences with the Envelope Theory

• The Just ME blogger, Sally Burch, has written about self-pacing and the energy envelope in a post called "Play-Up & Lay-Up" not "Boom & Bust".
• Brain Campbell, PhD, has included the Envelope Theory in chapter 7 of his manual, Recovery from Chronic Fatigue Syndrome: One Person's Story

Notable studies

• 2013, Energy Conservation/Envelope Theory Interventions to Help Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.
• 2008, The Energy Envelope Theory and myalgic encephalomyelitis/chronic fatigue syndrome. (Full text)

Learn more

• "Play-Up & Lay-Up" not "Boom & Bust" - Sally Burch
• Solve ME/CFS Initiative - Managing Your Energy Envelope by Bruce Campbell (pdf)
• Health Rising - Coping vs Energy Envelope in CFS

See also

• Post-exertional malaise
• Pacing
• Pacing with a heart rate monitor
• Bed rest
• Spoon theory
• Graded exercise therapy
• Activity management based on 2-day cardiopulmonary exercise testing results
• Mindfulness
• Meditation
• Coping strategies

Energy Envelope Theory A self-management tool developed and tested by Dr. Leonard Jason to reduce symptom severity and the frequency of post-exertional malaise or relapses for people with ME/CFS. According to this theory, ME/CFS patients should not expend more energy than they perceive they have, as this results in post-exertional malaise and higher disability. Instead patients are advised to stay within their energy envelope, meaning the physical limits the disease has imposed upon them. As the energy envelope theory also cautions about the dangers of under-exertion, its principles are almost identical to ‘pacing’, an activity management strategy for ME patients devised by Ellen Goudsmit in the UK.

Energy Envelope Theory A self-management tool developed and tested by Dr. Leonard Jason to reduce symptom severity and the frequency of post-exertional malaise or relapses for people with ME/CFS. According to this theory, ME/CFS patients should not expend more energy than they perceive they have, as this results in post-exertional malaise and higher disability. Instead patients are advised to stay within their energy envelope, meaning the physical limits the disease has imposed upon them. As the energy envelope theory also cautions about the dangers of under-exertion, its principles are almost identical to ‘pacing’, an activity management strategy for ME patients devised by Ellen Goudsmit in the UK.