Energy Envelope Theory

Pacing
Pacing is one way for those diagnosed with myalgic encephalomyletis to balance activity and rest.

The 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".
 * 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