By Colin Farrell, SPT
What are chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME)?
CFS and ME are complex conditions which cause debilitating symptoms of fatigue and malaise. The extent of fatigue varies from person to person, however, individuals with CFS often report physical and mental fatigue which greatly limits their ability to perform everyday activities and reduced quality of life. For some, doing a task like washing dishes causes overwhelming fatigue which can lead to worsening of symptoms which can last from days to even weeks.
These conditions belong to a category of illnesses which we know very little about. Technically, CFS and ME are two distinct conditions; however, because they present so similarly, they are often used interchangeably.
Interesting facts about CFS:
- Underdiagnosed – estimated that nearly 85-90% of individuals are undiagnosed
- Many medical providers don’t receive education or training on treating and managing CFS
- The cause of CFS is unknown
How is CMS diagnosed?
Typically, through a *comprehensive medical history and physical examination.
As well as the presence of the below symptoms, identified by the Centers for Disease Control:
1. Unable to participate in typical daily activities (school, work, etc.) due to fatigue which must be
present for at least 6 months.
2. Post-activity malaise – following any stressor. Whether that be physical, mental or emotional.
3. Poor sleep – Unrelenting feeling of tiredness which may or may not improve with sleep.
4. And finally, either
- Impaired memory and concentration
- Orthostatic intolerance (lightheadedness, dizziness, or in extreme cases passing out after standing from a seated position or lying down)
*Generalized pain, including muscle and joint pain and frequent headaches may also be present
Currently, there are no diagnostic or laboratory tests proven to help diagnose CFS.
Treatment options for CFS:
Medical treatments:
- Medications which help manage symptoms of CFS
- Cognitive behavioral training (CBT)
- Cognitive therapy
Can physical therapy help Chronic Fatigue?
Although treatment options for CFS vary, physical therapy is a recommended treatment option and may help improve quality of life.
Physical therapy treatment may include:
- Aerobic exercise/activities
- Strengthening exercise/activities
- Patient education – On pain neuroscience, energy conservation/management and activity modification
- Manual therapy – mobilization of soft tissues and joints to decrease pain and impove movement
REFERENCES
1. What is me/CFS? Centers for Disease Control and Prevention. March 21, 2023. Accessed July 1,2023. https://www.cdc.gov/me-cfs/about/index.html.
2. Larun L, Larun L, Brurberg KG, Odgaard-Jensen J, Price JR. Exercise therapy for chronic fatigue syndrome. Cochrane database of systematic reviews. 2019;2021(3):CD003200-CD003200.
doi:10.1002/14651858.CD003200.pub8
3. Treatment of ME/CFS. Centers for Disease Control and Prevention. Published 2019. https://www.cdc.gov/me-cfs/treatment/index.html
4. Guide | Physical Therapy Guide to Chronic Fatigue Syndrome. Choose PT. Published August 26, 2021.
https://www.choosept.com/guide/physical-therapy-guide-chronic-fatigue-syndr
