Chronic Fatigue Syndrome Treatment

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Chronic fatigue syndrome (CFS), also known as systemic exertion intolerance disease or myalgic encephalomyelitis, is a condition of extreme fatigue together with a group of other symptoms that are constantly present for at least six months.

Asian girl suffering from chronic fatigue - sleeping on bedImage Credit: TORWAISTUDIO / Shutterstock

What is chronic fatigue syndrome?

In most of the cases, CFS occurs suddenly after flulike infection or stressful events, such as surgery, traumatic experiences, etc. People with CFS are often hypersensitive to even a low level of physical activity, such as cleaning house, preparing food, or taking bath.  

Although the exact etiology is unknown, the onset of CFS can be triggered by several factors, such as viral infection, hormonal imbalance, nervous system problems, and impaired immune system.

The most common signs and symptoms of CFS includes extreme fatigue, loss of memory/concentration, severe muscle/joint pain, headache, lack of sleep, sore throat, enlarged lymph nodes in the neck area or armpits, and a severe reaction to exertion.    

How to treat chronic fatigue syndrome?

Since the symptoms of CFS are very much similar to many other health conditions, diagnosis is often very difficult. Doctors generally take detailed medical history of patients to rule out the possibilities of other illnesses, such as sleep disorder, cardiopulmonary disorders, psychological problems, or other medical conditions (anemia, diabetes, hypothyroidism, etc.).

Unfortunately, there is no proven cure for CFS. Since the intensity of fatigue and other related symptoms varies from person to person, a single approach may not be very effective for everyone. Doctors mostly recommend a combination of therapeutic interventions to reduce the symptom severity.

Initially, doctors ask patients to reduce/minimize the level of physical exertion and avoid psychologically stressful conditions. It is important to save the energy, which is already limited in CFS, for essential, vital activities.

The most important strategy for treating CFS is to understand and identify the most problematic symptom. Once identified, doctors primarily focus on managing the intensity of that particular symptom.

Following are the parameters that are frequently addressed by the doctors.

Activity management or pacing

The basic goal of an activity management method is to maintain balance between rest-activity cycle in daily life. A low level of physical exercise under the supervision of a physiotherapist can provide beneficial effects. A gradual but steady increase in exercise intensity can help reduce the extreme reaction to exertion. Mostly, physiotherapists recommend low-level of aerobic exercises to begin with. If a patient feels extremely exhausted after the exercise session, a physiotherapist may recommend avoiding exercise for several days and again resume it with a less-intensity exercise regimen.

For a CFS patient, the most important thing to remember is to avoid push-and-crash cycles. In simple words, they should avoid doing strenuous activities in their good days. This can lead to worsening of the condition afterward. Thus, for a CSF patient, an exercise regimen should be developed after careful evaluation of his/her tolerance level.

Sleep management

CFS patients often feel unrefreshed after sleep. Their energy level is not restored. The most common sleep problems include difficulty falling asleep, intense dreaming, extreme sleepiness, restless legs, and muscle spasm.

To avoid sleep-related problems, a patient should follow healthy sleep habits that include:

  • Maintain a particular sleep schedule
  • Try to relax before sleeping; avoid thoughts or activities that can cause stress, excitement, or anxiety
  • Avoid afternoon naps
  • Maintain a comfortable room temperature; avoid bright light and loud noise at night
  • Try to reduce the consumption of coffee, alcohol, and cigarette

In case a patient does not get sleep even after following a good sleep hygiene, a doctor recommends over-the-counter medicines or prescribed medicines that induce sleep.

Pain management

To reduce painful symptoms, such as headache, skin soreness, and muscle/joint pain, a doctor recommends over-the-counter pain-killers. Other pain management methods include heat treatment, gentle massage, stretching and toning exercises, water therapy, and acupuncture.

Stress management

A chronic fatigue condition often leads to psychological distress, including depression, stress, and anxiety. Antidepressants and anti-anxiety medicines can be effective in alleviating these symptoms. However, proper care should be taken while prescribing these medicines because some of these medicines may have side-effects that can worsen other symptoms.

People with CFS can also be benefitted from certain stress management methods, such as yoga, meditation, muscle relaxation, movement therapies, talk therapies, etc.

Orthostatic intolerance

CFS patients often suffer from dizziness, weakness, lightheadedness, vision problems, and restlessness. In such cases, a specialized doctor initially checks the heart beat and blood pressure and prescribes appropriate medicines. If a patient is not suffering from any cardiovascular disorder, a doctor may recommend increasing the fluid and salt consumption and using support stockings.

Concentration problems

CFS patients who suffer from a lack of concentration may be benefitted from stimulants, including those used to treat Attention-Deficit / Hyperactivity Disorder. However, proper care should be taken to avoid the induction of push-and-crash cycles.   

Sources

Further Reading

Last Updated: Sep 16, 2019

Dr. Sanchari Sinha Dutta

Written by

Dr. Sanchari Sinha Dutta

Dr. Sanchari Sinha Dutta is a science communicator who believes in spreading the power of science in every corner of the world. She has a Bachelor of Science (B.Sc.) degree and a Master's of Science (M.Sc.) in biology and human physiology. Following her Master's degree, Sanchari went on to study a Ph.D. in human physiology. She has authored more than 10 original research articles, all of which have been published in world renowned international journals.

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