Pacing for Long Covid: Patient Experiences Studies

A key strategy for managing post-exertional malaise and symptom exacerbation in Long Covid is to use pacing.

Two studies have explored the experiences of people living with Long Covid when using pacing. A mixed methods study in 2025 explored explored how non-hospitalised people with Long Covid experience pacing (energy management). A second study carried out online interviews with people living with Long Covid.

Below is an infographic detailing the findings of the two studies followed by a more detailed written summary.

Combined summary of findings

Together, these two studies show that pacing (energy management) is widely used by people with Long Covid and can help manage symptoms—particularly post-exertional malaise (PEM)—but is not straightforward to implement and is not a cure.

Key insights

1. Pacing is helpful – but not a cure

• Participants consistently described pacing as beneficial but insufficient on its own.
• It helps stabilise symptoms rather than resolve the condition.  

2. It is complex and constantly changing

• Pacing is experienced as a “moving target”, requiring ongoing adjustment.  
• What works one day may not work the next due to fluctuating symptoms.

3. Learning to pace is difficult

• People often have to teach themselves pacing strategies, with limited formal guidance.  
• There is variation in understanding and implementation, including risks from inappropriate approaches (e.g. pushing activity increases).  

4. Real-life barriers make pacing hard

• Work, family responsibilities, and financial pressures can limit the ability to pace effectively
• Participants reported stigma, misunderstanding, and pressure to “push through” illness  

5. Not pacing has clear consequences

• Failure to pace was linked to worsening symptoms and increased crashes (PEM).  

6. Support and guidance are lacking

• Both studies highlight the need for:
  • Clear, evidence-based guidance
  • Healthcare professional support
  • Better access to pacing education and tools  

Overall conclusion

Across both studies, pacing emerges as a core self-management strategy for Long Covid, but one that is:

• Difficult to implement consistently
• Highly individual and context-dependent
• Undersupported by current healthcare systems

The evidence highlights an urgent need for clear clinical guidance, patient support, and further research to ensure pacing is used safely and effectively.

Download the full articles by clicking here and here.

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