Energy Envelope Theory

Pacing
Pacing is one way for those diagnosed with myalgic encephalomyelitis (ME) to balance activity and rest and may even reduce symptom severity and the frequency of relapses. Day-to-day energy levels for those with ME are often unpredictable; however, pacing allows patients 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. Pacing encourages ME patients to accept their daily energy limitations and not exceed or fight them. Pacing is based on four main principles, and when practiced it can help to "support the body's natural recovery process ." The four goals to pacing are activity, rest/relaxation, establishing a baseline, and increasing activity as you are able.

Activity: every individual has his or her own definition of what it means to be active and therefore,

The Energy Envelope Theory
The Energy Envelope Theory 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".
 * Bruce 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 (Full Text)
 * 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