• Maria Arini Lopez, PT, DPT, CSCS, CIMT, CMTPT

Save Your Spoons!

An Energy Conservation Strategy for People Living with Chronic Illnesses September 30, 2022 - Written By: Maria Arini Lopez, PT, DPT

People who do not live with chronic pain or debilitating fatigue do not understand how much energy it takes for those who are living with chronic illnesses just to perform normal everyday tasks. Getting out of bed in the morning, taking a shower, dressing, going grocery shopping, making dinner, going to doctors’ appointments, or socializing with friends can feel like running a marathon under the best of circumstances.

Enter the Spoon Theory.

The Spoon Theory was created on the spot by Christine Miserandino who was trying to describe how living with lupus felt like to her curious friend while they ate lunch at a diner. Miserandino handed 12 spoons to her friend and asked her friend to go through her daily routine. For each activity, Miserandino removed a spoon which represented the energy it took to complete that task. Once the spoons were gone, this meant that no energy was left to do anything else that day.

Through her Spoon Theory analogy, Miserandino explained how those who are healthy have an unlimited number of spoons per day, while those living with chronic illnesses must consciously choose how they will spend their energy each day. People with autoimmune conditions, chronic pain, or chronic fatigue must make choices each day to protect the limited number of spoons they have.

To make things more challenging, the number of spoons changes from day to day. Some days you may wake up with more spoons, while other days, you may have little to no energy in the tank. It may depend on whether your symptoms are flaring up or if you have found medications that successfully work to keep the flares to a minimum. It also may depend on the quality of sleep you are getting each night.

Typically, sleep is the only way to restore the number of spoons, so people who experience insomnia, painsomnia, or do not get enough restorative hours of sleep each night may have significantly less spoons on a daily basis.

The Spoon Theory is routinely used as part of the language of chronic illness. Many people living with chronic illnesses strongly identify with this analogy, calling themselves “spoonies” and telling friends and family they do not have enough spoons for certain events or tasks.

Ways to Manage and Protect Daily Spoons

Several things might help to conserve or possibly increase your number of daily spoons.

  • Physical Therapy – Strengthening the body may make daily tasks easier and less energy-consuming

  • Complementary Medicine – Routine self-care visits to a massage therapist, acupuncturist, or chiropractor may help to manage pain.

  • Pain Management Programs – These programs provide strategies and treatments to manage pain

  • Medications – Certain medications may decrease pain intensity and help you to get a better night’s sleep to restore your spoons.

  • Meditation/Mindfulness– Daily meditation may enable acceptance of the chronic fatigue and pain instead of mentally fighting against it (which may cost spoons).

  • Planning Ahead – Scheduling only a certain number of events per day or per week while leaving extra spoons in case of unforeseen events or necessities may help to conserve your spoons while making sure you don’t run out.

  • Changing Plans – If you wake up with less spoons than anticipated, try to reschedule the things on that day that can be pushed back.

  • Take Frequent Breaks – Try to leave time in between scheduled events for sufficient rest and recovery.

  • Say No – No is a complete sentence. It is ok to say no to things that you know you will not be able to do. It is ok to say no to things you know will cost you a lot of spoons.

Bottom Line

Even if other people don’t understand exactly what you are going through living with a chronic illness, you must take the steps necessary to look after your own physical and mental well-being. Protect your spoons and use them wisely!


References and Resources

  1. Miserandino C. https://butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/ Accessed September 29, 2022.

  2. What Is the Spoon Theory Metaphor for Chronic Illness? Cleveland Clinic. Accessed September 29, 2022.

  3. Schultz K. I’m a “Spoonie.” Here’s What I Wish More People Knew About Chronic Illness. Healthline. Accessed September 29, 2022.

  4. Cristol H. What Is the Spoon Theory? WebMD. Accessed September 29, 2022.

Maria Arini Lopez, PT, DPT

Maria Arini Lopez, PT, DPT, CSCS, CIMT, CMTPT is a freelance medical writer and Doctor of Physical Therapy from Maryland. She has expertise in the therapeutic areas of orthopedics, neurology, chronic pain, gastrointestinal dysfunctions, and rare diseases, especially Ehlers Danlos Syndrome.

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