Chronic Fatigue Syndrome – A Definition
Chronic fatigue syndrome (CFS), is a complicated medical condition that causes severe fatigue that becomes worse with physical activity. CFS fatigue symptoms do not improve with rest. Usually, patients who have CFS cannot sustain the same amount of activity as before they developed the disorder.
In addition to fatigue, chronic fatigue syndrome may cause other generalized symptoms such as muscle weakness and pain, insomnia and impaired ability to concentrate.
The medical profession has defined the following two criteria for for chronic fatigue syndrome:
Severe, debilitating fatigue for six months or longer, with an exclusion of other medical conditions. Coexisting with this fatigue, at least four of the following symptoms: sore throat; tender lymph nodes; multi-joint pain without swollenness or inflamation; muscle pain; headaches not experienced before in pattern or severity; awakening from sleep and not feeling rested. These symptoms must not have been experienced before chronic fatigue. They also must have recurred or persisted for at least six months.
Symptoms of Chronic Fatigue Syndrome
Symptoms of chronic fatigue syndrome often last for years and vary. In most cases, the disability affects daily living in a significant manner. The symptom of key importance is the unrelenting, severe fatigue that persists for at least six months. This fatigue worsens with activity, and does not improve with rest.
In some cases, CFS symptoms become worse for a time and then symptoms get better for a time. This suggests a pattern of relapse and remission. It is thought that becoming too active during remission can bring on a relapse of symptoms.
Other common symptoms of CFS include:
– Headaches (type not previously experienced
– Joint pain without swelling or inflammation
– Generally feeling unwell, that lasts for at least 24 hours.
– Difficulty concentrating
– Loss of memory
– Painful muscles and joints
– Unrestful sleep
– Sore throat
– Sore lymph nodes
To make a CFS diagnosis the following criteria must be present in the patient:
Severe, debilitating fatigue for six months or longer, with an exclusion of other medical conditions.
Simultaneously, at least four the following symptoms: sore throat; tender lymph nodes; multi-joint pain without swollenness or inflamation; muscle pain; headaches not experienced before in pattern or severity; awakening from sleep unrefreshed. These symptoms must not have been experienced before chronic fatigue. They also must have recurred or persisted for at least six months.
A thorough physical examination must be carried out to detect other symptoms of CFS, such as fever and swollen lymph nodes and to rule out other medical conditions with similar symptoms. Laboratory tests that may be used to rule out other conditions include blood tests (e.g., white blood cell count) which could indicate a similar disorder, mononucleosis. Imaging tests such as MRI must be carried out.
The following medical conditions must be ruled out:
– Autoimmune disorders
– Dependecy on drugs
– Fatigue related to psychological factors alone (depression)
– Heart, kidney, or liver disease
– Muscle or nerve diseases (multiple sclerosis)
Since symptoms vary, patients with CFS need medical treatment that addresses the patient’s individual symptoms. Most often, treatment programs are devised by a team of health care providers, such as a team of physicians, physical therapists, mental health personnel and dieticians. Over-the-counter and prescription medications may be used to reduce symptoms of CFS such as pain and depression.
Patients must learn how to manage and monitor activity levels and rest and sleep periods. Usually the correct level of activity and rest will improve symptoms. The aim of treatment is to correctly balance periods of activity and rest, lower pain and stress andf improve sleep.
Different types of treatments that may be beneficial include the following:
– Deep breathing techniques
– Muscle relaxation
– Tai chi (type of movement therapy)