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How can I manage my symptoms by pacing?

We do not recommend any individual treatments or management approaches for people with M.E. Instead, we offer key information to allow people with M.E. to make informed decisions.

Self-management includes taking control of the balance of activity and rest, and learning how to communicate to other people about the balance that usually works best for you.

This balancing out of activity and rest is sometimes called “energy management”, “activity management” or simply “pacing.”

It is all about balancing activity and rest to bring about more stability in your symptoms, and what you can manage every day. It also offers you an opportunity to control the consequences of your illness. Whilst it does take self-control and patience, the stability it brings will help you to take decisions about whether or not you build up activity.

The word "activity" is used in a broad sense, to include mental and emotional activity, as well as the more obvious physical sort. For some, activity may be very minimal (especially for those who are severely affected) yet still cause considerable impact on energy and symptoms.

Taking a balanced, steady approach to activity counteracts the common tendency to overdo things. Keeping your activity levels within sensible limits avoids overly aggravating your symptoms and prolonging the recovery phase after the increased activity. You also know that if the activity is within your limits, you have a realistic chance of achieving the activity as planned. Understanding and accepting what your current abilities are helps you to plan ahead with more confidence. Everyone will have different limits and this may change over time.

Energy management gives you awareness of your own sustainable ability levels which enables you to better plan the way that you use your energy, maximising what you can do with it. Over time, when your condition stabilises, you have the option of trying very gradually increase your activities to work towards improvement.

The practicalities of energy management are not set in stone and there are different interpretations of how they can be applied. Our 2014 M.E. time to deliver survey report found that:

  • 67% of respondents used pacing to help them manage M.E.
  • 67% used rest, including bed rest.

Of these:

  • 85% of people said pacing was helpful or very helpful (12% said it made no difference, and 4% said it made them a bit or much worse).
  • 89% of people said rest, including bed rest was helpful or very helpful (10% said it made no difference, and 1% said it made them a bit or much worse).

Our Pacing for people with M.E. booklet is based on the practical experience and clinical practice of clinicians and therapists, and the feedback Action for M.E. has received from people with M.E.