Tired most of the time

Chronic fatigue syndrome is a condition that leads to symptoms of persistent fatigue that do not resolve after rest or sleep.

The medical term used for this condition is myalgic encephalomyelitis and chronic fatigue syndrome is also know of as ME. The term myalgic encephalomyelitis can be broken up into “myo” meaning muscle, “algia” meaning pain and encephalomyelitis meaning inflammation of the brain and spinal cord.

Chronic fatigue syndrome is an under-diagnosed condition that can seriously impact on normal day-to-day living and even cause disability, although many people recover over time, especially young people and children.

Chronic fatigue syndrome may affect any individual but is more common in women than in men and in those aged between 20 and 50 years. Among children, the condition usually develops between the ages of 13 and 15. 

Symptoms and course of the disease

In three quarters of all patients with this condition, the symptoms are mild to moderate. In the case of mild symptoms, patients can usually take care of themselves but may take time off from work to rest. Moderate symptoms can cause mobility problems and disrupted sleep patterns. In severe cases, individuals may be able to carry out the most simple of tasks such as washing their face but mobility is significantly reduced and concentration is diminished.

Cause of chronic fatigue syndrome

The exact cause of this condition is not known but some studies have indicated that viral infection, immune disorder, hormonal imbalance or psychiatric issues such as emotional trauma may play a role.

Diagnosis

According to criteria form the National Institute of Health and Clinical Excellence (NICE), the fatigue criteria that need to be fulfilled for a diagnosis of chronic fatigue syndrome include:

• No previous history, so new onset
• Persistent
• Unexplained by other conditions
• Substantially impacts on activity level
• Feels worse after physical activity

In addition, one or more of the following criteria need to be met:

• Sleeping difficulty or insomnia
• Difficulty thinking or concentrating
• Headache
• Joint pain
• Sore throat
• Painful lymph nodes
• Worsening of symptoms after activity
• General malaise or flu-like symptoms
• Dizziness
• Nausea
• Heart palpitations

Treatment

Chronic fatigue syndrome cannot be cured and treatment is aimed at reducing symptoms. Some of the most common treatments used are cognitive behavioural therapy (CBT), graded exercise therapy and medications that alleviate pain, sleep disturbances and nausea.

Activity planning

Any activity or exercise plan for people with ME/CFS needs to be carefully designed based on the individual patient's presentation. Planning should take into account the patient's input.

If possible, evaluation by a rehabilitation specialist may be beneficial. For some patients, even daily chores and activities such as cleaning, cooking, or showering can be difficult. These tasks may need to be broken down into shorter, less strenuous pieces.

While vigorous aerobic exercise can be beneficial for many chronic illnesses, patients with ME/CFS cannot tolerate such exercise routines. Standard exercise recommendations for healthy people can substantially harm patients with ME/CFS.

It is important that patients with ME/CFS maintain activities they can tolerate since deconditioning is also harmful. For some patients, it might be necessary to treat orthostatic intolerance first. Improving patients' capacities to tolerate being upright should be accomplished before any activity can be considered for careful implementation.

Patients who can tolerate their current activity level and know how to "listen to their bodies" might benefit from carefully increasing exercise. This may help them improve their physical fitness and avoid deconditioning.

Some healthcare providers with expertise in ME/CFS refer their patients to an exercise physiologist who understands ME/CFS. These providers should use an individualized and flexible approach to advancing activity levels.

If exercise plans are not designed and executed carefully, patients may experience setbacks and serious deterioration in function and health. Expectations need to be managed, as exercise is not a cure.

However, improved function is a long-term goal of managing ME/CFS. Tolerance of aerobic exercise and normal activity levels is also a long-term goal but it should be pursued cautiously. - Source: MedicalScienceNet

Did you know?

Blood

A blood test has achieved 96% accuracy in diagnosing the condition in a small study of individuals.