At the Pain Collective, we have a massive, combined expertise in managing patients with chronic pain. Chronic is frequently due to underlying chronic diseases. Living with chronic illness often means living with invisible limits—especially around energy. You may look fine on the outside yet feel utterly depleted by basic tasks. That’s where Spoon Theory comes in.
This simple but powerful metaphor has become a common language for people navigating chronic pain, fatigue, and disability. It helps explain why some days feel impossible, why pacing is essential, and how energy can vanish without warning.
Whether you’re someone managing chronic illness or trying to support someone who is, Spoon Theory offers insight, empathy, and a way to talk about it.
What Is Spoon Theory?
Spoon Theory was created by Christine Miserandino, a writer and patient advocate living with lupus. In her now-famous 2003 blog post, The Spoon Theory, she described trying to explain to a friend what it’s like to live with an invisible illness.
Sitting in a diner, she grabbed spoons from nearby tables and handed them to her friend. Each spoon represented a unit of energy.
She explained:
- Every action in a day costs spoons—getting out of bed, showering, driving, working, socialising.
- Healthy people tend to have unlimited or renewable energy. But those with chronic illness start each day with a limited supply.
- Once your spoons are gone, they’re gone. You can’t just push through.
Some days, you might wake up with 10 spoons. Others, only 4. That unpredictability is part of the struggle.
The metaphor resonated. Soon, online communities embraced the term “spoonie” to describe those living with chronic health challenges.
The Meaning Behind the Metaphor
Spoon Theory is more than just a visual aid—it’s a communication tool that fosters understanding.
For someone with chronic fatigue or pain, it’s difficult (and often exhausting) to repeatedly explain why they can’t go out, cancel plans, or need more rest than others. Saying “I’m out of spoons today” quickly communicates the reality of their limits without needing a full explanation.
Examples of Spoon Costs:
- Getting dressed: 1 spoon
- Cooking a meal: 2 spoons
- Attending a meeting: 3 spoons
- Managing pain during a flare-up: 4 spoons
- Socialising for an hour: 3 spoons
- Driving: 2 spoons
Spoon management becomes a daily negotiation—what can I afford to do today, and what must I give up?
Who Uses Spoon Theory?
Spoon Theory has been widely adopted across many communities, especially those living with chronic, fluctuating, or invisible illnesses. Common examples include:
- Lupus
- Chronic fatigue syndrome (ME/CFS)
- Fibromyalgia
- Multiple sclerosis (MS)
- Rheumatoid arthritis
- Ehlers-Danlos Syndrome
- Depression and anxiety
- Long COVID
It’s also found in neurodivergent communities, including those with ADHD and autism, where energy and sensory processing challenges are common.
Even individuals navigating burnout or recovering from trauma have found value in Spoon Theory as a model for pacing and self-awareness.
Why Spoon Theory Matters
Spoon Theory matters because it gives language to lived experience.
People with chronic conditions are often misunderstood. They may face:
- Assumptions that they're lazy or unmotivated
- Pressure to "push through"
- Guilt when they can’t keep up
- The emotional toll of constantly justifying themselves
By explaining energy as a finite resource, Spoon Theory helps:
- Build empathy with friends, family, colleagues, and healthcare providers
- Reduce shame and internalized stigma
- Empower individuals to advocate for their needs
- Facilitate honest conversations in medical and workplace settings
It's not just about limitations—it’s about making informed, compassionate choices.
Limitations and Criticisms of the Theory
While Spoon Theory has helped many, it’s not universal.
Common critiques include:
- It may oversimplify complex illnesses or disability experiences.
- Not everyone resonates with the spoon metaphor—some prefer battery metaphors or energy pennies.
- It assumes energy is the central limitation, when for others, pain, mobility, or cognition may be more dominant challenges.
That said, many still find it a helpful starting point, even if they adapt it to suit their unique needs.
How to Support Someone Who’s “Out of Spoons”
If someone you care about describes themselves as a spoonie, here’s how you can show support:
Believe them
Just because they look fine doesn’t mean they feel fine. Trust what they tell you about their energy levels and pain.
Avoid judgment
Statements like “You were fine yesterday” or “But you were just out with friends” ignore how fluctuating and unpredictable chronic illness can be.
Offer practical help
Small gestures—dropping off a meal, helping with errands, or simply being flexible with plans—can make a big difference.
Don’t take “no” personally
If a spoonie cancels or seems withdrawn, it’s rarely about you. They may just be out of spoons.
Conclusion: Spoon Theory as a Tool for Connection
Spoon Theory doesn’t explain everything—but it explains enough to make people feel seen, supported, and understood.
Whether you're living with a chronic condition or supporting someone who is, Spoon Theory reminds us that compassion is essential, even (and especially) when we don’t fully understand.
And perhaps most importantly—it gives people the right to prioritise their health without guilt.
Speak to a Specialist Who Understands
FAQs
1. What is Spoon Theory in simple terms?
Spoon Theory is a metaphor that uses spoons to represent units of energy. People with chronic illness often have limited “spoons” each day and must choose how to use them carefully.
2. Who came up with Spoon Theory?
Christine Miserandino created Spoon Theory in 2003 to explain her experience of living with lupus.
3. What does it mean to be a “spoonie”?
A “spoonie” is someone who uses Spoon Theory to describe their experience of living with chronic illness, fatigue, or disability.
4. Can healthy people use Spoon Theory to understand burnout?
Yes. While designed for chronic illness, the metaphor can help healthy individuals understand energy limits due to stress, trauma, or burnout.
5. Is Spoon Theory only for physical illnesses?
Not at all. Spoon Theory is also used by people with mental health conditions, neurodivergence, and invisible illnesses.
About the Author
Dr Willem Adriaan Liebenberg, MBChB, MMed (Neurosurgery), FCS (Neurosurg) SA
Dr Liebenberg is a neurosurgeon and founder of The Pain Collective, a national network of interdisciplinary pain clinics across South Africa. With over 20 years of clinical experience, he specialises in minimally invasive spine care and holistic chronic pain management. He is also Director of The Health Collective and a Council Member of PainSA.