From the Guidelines
Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), is characterized by profound fatigue that doesn't improve with rest and worsens with physical or mental activity, accompanied by a substantial reduction or impairment in the ability to engage in pre-illness levels of occupational, educational, social, or personal activities for at least 6 months, as noted in the most recent study 1.
Symptoms of Chronic Fatigue Syndrome (Myalgic Encephalomyelitis)
The symptoms of CFS/ME include:
- Extreme exhaustion lasting more than 24 hours after physical or mental exertion
- Unrefreshing sleep
- Cognitive difficulties (brain fog)
- Orthostatic intolerance (dizziness when standing)
- Muscle and joint pain
- Headaches
- Sore throat
- Tender lymph nodes
- General malaise
- Post-exertional malaise (PEM), where symptoms significantly worsen after even minor physical or cognitive effort
- Digestive issues
- Sensitivity to light and sound
- Temperature regulation problems These symptoms often fluctuate, with some patients experiencing mild symptoms while others become severely disabled and bedridden, with up to 75% of people with ME/CFS unable to work full-time and 25% having severe ME/CFS, which often means they are bed-bound, have extreme sensitivity to sensory input and are dependent on others for care 1.
Diagnosis and Treatment
Diagnosis typically involves ruling out other conditions that could cause similar symptoms, as there is no specific test for CFS/ME. The condition often begins after a viral infection or significant stress, suggesting an immune system trigger, though the exact cause remains unknown. Treatment focuses on symptom management rather than cure, with pacing activities to avoid PEM being a cornerstone of management. Cognitive-behavioral therapy and mindfulness-based therapies have been suggested as potential treatments for CFS/ME, as they have been shown to improve health function, health-related quality of life, or physical function in patients with CMI and symptoms consistent with ME/CFS 1.
From the Research
Symptoms of Chronic Fatigue Syndrome (Myalgic Encephalomyelitis)
The symptoms of Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis, include:
- Persistent, medically unexplained fatigue 2, 3, 4
- Musculoskeletal pain 3, 4
- Sleep disturbance 3, 4
- Headaches 3, 4
- Impaired concentration and short-term memory 3, 4
- Physical impairment 5, 6
- Depression 2, 5
- Anxiety 2, 5
- Somatic and psychological attributions 5
- Somatic focus 5
- Sense of control over symptoms 5
Diagnosis and Assessment
Diagnosis of CFS involves a detailed assessment of symptoms, associated disability, and coping strategies, as well as an evaluation of possible comorbid psychiatric disorders such as depression or anxiety 2. A firm and positive diagnosis of CFS can be made when no alternative physical or psychiatric disorder can be found to explain the symptoms 2.
Treatment and Management
Treatment of CFS may involve cognitive behavioral therapy (CBT) 2, 5, graded exercise therapy (GET) 5, and other interventions aimed at overcoming illness-perpetuating factors such as inconsistent activity, sleep disorder, and misunderstanding of the illness 2. Exercise therapy has been shown to be effective in reducing fatigue and improving sleep, physical functioning, and self-perceived general health 3, 4.