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Boom and bust activity cycle
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==Boom and bust == When ME/CFS patients become worse after pushing through their symptoms, people with ME/CFS then have to choose again between [[rest]] or trying again to "push through" - which causes them to deteriorate further, until eventually they physically cannot continue. Both resting and pushing through result in an "[[greatly lowered ability to do activities that were usual before the illness]]", a symptom that is required for the diagnosis of ME/CFS.<ref name="CDC-symptoms">{{Cite web |url = https://www.cdc.gov/me-cfs/symptoms-diagnosis/symptoms.html | title = Symptoms {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | website = [[Centers for Disease Control and Prevention]] | date = Jan 27, 2021 | access-date = 2021-02-25}}</ref><ref name="niceng206">{{Cite web | url = https://www.nice.org.uk/guidance/ng206 | title = Myalgic Encephalomyelitis (or Encephalopathy)/Chronic Fatigue Syndrome:diagnosis and management. NICE guideline. | last = NICE Guideline Development Group | first = | author-link = | publisher = [[National Institute for Health and Care Excellence]] | date = 2021-10-29}}</ref> The cycle of repeatedly exceeding energy limits by doing too much activity or even [[pushing through symptoms]] followed by being forced to totally stop is called the "[boom and bust cycle", and is very widely recognized in ME/CFS, and in some patients without post-exertional malaise, including [[chronic pain]] and [[chronic fatigue]] patients.<ref name="Antcliff2021">{{Cite journal | title = “Pacing does help you get your life back”: The acceptability of a newly developed activity pacing framework for chronic pain/fatigue | url =https://onlinelibrary.wiley.com/doi/abs/10.1002/msc.1557 | journal = Musculoskeletal Care | volume = n/a | issue = n/a | last = Antcliff | first = Deborah | last2 = Keenan | first2 = Anne-Maree | last3 = Keeley | first3 = Philip | last4 = Woby | first4 = Steve | last5 = McGowan | first5 = Linda|language=en|doi=10.1002/msc.1557|issn=1557-0681}}</ref> A significant proportion of people with [[Long COVID]] report experiencing post-exertional malaise and find they have a boom and bust cycle.<ref name="Horton2010">{{Cite journal | title = Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in adults: a qualitative study of perspectives from professional practice | date = 2010-11-15 | url = https://doi.org/10.1186/1471-2296-11-89 | journal = BMC Family Practice | volume = 11 | issue = 1 | pages = 89 | last = Horton | first = Simon MC |author-link = | last2 = Poland | first2 = Fiona | author-link2 = | last3 = Kale | first3 = Swati | author-link3 = | last4 = de Lourdes Drachler | first4 = Maria | author-link4 = | last5 = de Carvalho Leite | first5 = Jose Carlos | author-link5 = | last6 = McArthur | first6 = Maggie A. | author-link6 = | last7 = Campion | first7 = Peter D. | last8 = Pheby | first8 = Derek | author-link8 = Derek Pheby | last9 = Nacul | first9 = Luis | author-link9 = Luis Nacul |doi=10.1186/1471-2296-11-89|pmc=PMC2994803|pmid=21078171|access-date=|issn=1471-2296|quote=|via=}}</ref>
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