From the Guidelines
A treatment or cure for Chronic Fatigue Syndrome (CFS) is unlikely to be available in the near future, and patients should focus on managing their symptoms through evidence-based therapies such as cognitive-behavioral therapy, as recommended by the 2021 US Department of Veterans Affairs and US Department of Defense clinical practice guideline 1.
Current Management Options
The current management of CFS focuses on symptom relief and improving quality of life. According to the 2021 US Department of Veterans Affairs and US Department of Defense clinical practice guideline, cognitive-behavioral therapy has the greatest evidence for improving health function, health-related quality of life, or physical function in patients with CFS 1.
- Cognitive-behavioral therapy has been shown to improve physical functioning in ME/CFS compared to control, with 44.3% of participants in the cognitive-behavioral therapy arms improving 20% or more on health-related quality of life compared to 31.5% of participants in the control arms 1.
- Mindfulness-based therapies also have strong evidence supporting their use in patients with CFS, with improvements in daily functioning and quality of life 1.
Future Directions
While a cure for CFS is not currently available, research is ongoing in several promising areas, including immune system dysfunction, mitochondrial abnormalities, and neuroinflammation. The complexity of CFS has slowed progress, but increased research funding and recognition of CFS as a biological illness rather than a psychological condition are accelerating understanding 1.
- Recent developments in long COVID research may also benefit CFS treatment, as the conditions share similarities.
- Patients should work with healthcare providers knowledgeable about CFS to develop personalized management strategies while staying informed about emerging treatments through reputable patient advocacy organizations.
From the Research
Current Treatment Options for Chronic Fatigue Syndrome (CFS)
- Exercise therapy is a commonly used treatment for CFS, which has been shown to reduce fatigue and improve physical functioning 2, 3, 4.
- Cognitive behavioral therapy (CBT) is also used to treat CFS, and has been shown to be effective in reducing fatigue and improving quality of life 5, 6.
- Other treatment options, such as adaptive pacing and pharmacological therapy, have also been studied, but the evidence for their effectiveness is limited 2, 3, 4.
Effectiveness of Exercise Therapy
- Exercise therapy has been shown to reduce fatigue in adults with CFS, with a moderate to large effect size 2, 3, 4.
- Exercise therapy may also improve physical functioning, sleep, and self-perceived changes in overall health, but the evidence is not as strong 2, 3, 4.
- The effectiveness of exercise therapy compared to CBT is uncertain, with some studies showing little or no difference between the two treatments 2, 3, 4.
Future Directions for Treatment
- Further research is needed to determine the most effective type, duration, and intensity of exercise therapy for CFS 2, 3, 4.
- Studies are also needed to compare the effectiveness of different treatment options, such as CBT, adaptive pacing, and pharmacological therapy 2, 3, 4.
- The development of new treatments, such as medications or other therapies, may also be necessary to improve outcomes for individuals with CFS.
Predictors of Treatment Outcome
- Sense of control over symptoms and physical activity level have been shown to be predictors of treatment outcome in CFS patients 6.
- Other factors, such as duration of fatigue and receipt of disability insurance benefits, may also influence treatment outcome 6.
- Further research is needed to identify other predictors of treatment outcome and to develop personalized treatment plans for individuals with CFS.