There have been cases of full recovery but unfortunately, the majority of ME patients never recover completely. And this counts for those receiving treatment as well. The condition is more or less successfully managed with several therapies; which ones depends greatly on the symptoms and their severity. In most cases, ME management involves the use of a combination of multiple therapies and treatments. These often include cognitive behavioural therapy (CBT) and graded exercise (GET), both of which have been shown moderately effective when combined with specialist medical care (SMC). But in the recent years, ME management often also includes the so-called pacing which, according to patient survey, is helpful in over 80% of cases.
Pacing is a form of ME therapy which foresees increasing both physical and mental activity in a way to avoid worsening of the condition’s symptoms. Unlike CBT, pacing takes into account the periodic improvement and worsening of ME symptoms as well as a significant delay in recovery from exercise in comparison to healthy individuals. The therapy is based on setting realistic and manageable intensity and duration of activity which is carefully balanced with the rest period in order to prevent worsening of the symptoms. Duration and intensity of activity are increased gradually over a longer period of time with an aim to improve the patient’s physical and mental functioning in the long term.
Pacing works by encouraging the patient to make both physical and behavioural/psychological changes which eventually lead to improvement of ME symptoms and hopefully, enable the patient to live a normal or nearly normal life. As mentioned above, the key is to achieve a balance between resting and (both physical and mental) activity in order to avoid making the symptoms worse and at the same time, gradually increase the activity level. On a psychological level, pacing helps the patient determine their limits, enabling them to make plans and make the most out of their day which has a very positive effect on their psychological well-being. On a physical level, pacing enables ME patients not only to determine their limits but also to gradually increase endurance without suffering any adverse effects.
Under condition that it is adjusted to individual condition, pacing is safe and effective for the majority of ME patients, no matter if suffering from severe or mild form.