Thou learning to pace and putting myself completely first before all other things, was essential to my improvement (i wasnt left with any choice but to learn how to do that after the ME kicked my butt and left me completely bedbound and unable to even look after myself for 9mths.. so after that happened and I started to improve enough to get out of bed and go to the loo and shower on occassions.. I KNEW I had to put myself first.. I didnt want have no choice but to have to spend another year in bed!!) Finding out the abnormalities I have is the other thing which has been essential for my improvement as I platoed at a point when I'd finally got the pacing right and couldnt get any more better then I was. So many things may stop it from getting worst 1/ Working with the illness rather then against the illness is a huge one. 2/ Having a good ME/CFS specialist who knows what tests to do to find the various issues which are in ME/CFS. We all have abnormalities its just a fact that many doctors are doing the wrong tests as they do tests to rule out things, rather then doing tests to find out what abnormalities the ME/CFS itself has caused. (most doctors unless they are a good ME/CFS specialist dont even know what abnormalities there is often found in ME/CFS.. If you asked your current doctor.. does he know? There is a large amount of common abnormalities found in ME). Once you are aware of your abnormalities.. it helps give a guide of what treatments may be most useful for your ME/CFS be it antivirals or whatever. The sooner you have a knowlegable doctor, the sooner you can be trialing things which "may" help. Never give up cause a not knowledgable doctor has. I know tests cost money but when we do find something which we can treat some.... the improvement may be worth it. If you are low on money.. focus on ME/CFS tests in which if something is found you can do some kind of treatment eg POTS testing if it was thought you could possibly have POTS (POTS can cause headaches esp if one is standing or has been on feet too long). I hope you didnt put much time and money into the physiotherapy.. that is often useless to a ME patient and can actually keep them sick. It is quite possible that those walks are possibly causing a worsening of your condition. I wonder if you would get any improvement with doing less overall and avoiding the walks for at least a few weeks (as long as you didnt replace that activity with others). Looking after your ME may have to be put before your physical fitness. Constantly declining..usually shows that there is something you need to change. Many of us at this site couldnt go for regular walks without ending up causing our condition to start to decline. (watch out for food issues.. they are often something which happens in ME but one can take quite a while to realise they are starting to get symptoms from foods. That was one area my realisation was slow with and like often sneaks up). "Most" people who have ME can get improvement or at least some stability of their illness after a while. It will plato at some point but how bad things will be at that point, all may depend on the things you are doing now before that point. At some point you will figure out your illness more. The first 5-6 years of my illness.. I didnt get into a stabilisation point.. I was either on a long path of getting worst or a long path of very very slow improvement (to remission) It was only in my second bout of getting ME that my illness got to a point where it reached a stable point, in which it stays the same long term and without finding some kind of treatment to help more (ive got ideas), Im now stuck here at this point.