Chronic fatigue syndrome is a condition of prolonged and severe tiredness or weariness (fatigue) that is not relieved by rest and is not directly caused by other conditions.
See also: Fatigue
CFS; Fatigue - chronic; Immune dysfunction syndrome; Myalgic encephalomyelitis (ME)
The exact cause of chronic fatigue syndrome (CFS) is unknown. Some researchers suspect it may be caused by a virus, such as Epstein-Barr virus or human herpes virus-6 (HHV-6). However, no specific virus has been identified as the cause.
Studies suggest that CFS may be caused by inflammation along the nervous system, and that this inflammation may be some sort of immune response or process.
Other factors such as age, prior illness, stress, environment, or genetics may also play a role.
CFS most commonly occurs in women ages 30 to 50.
The Centers for Disease Control (CDC) describes CFS as a distinct disorder with specific symptoms and physical signs, based on ruling out other possible causes. The number of persons with CFS is unknown.
CFS is diagnosed after the health care provider rules out other possible causes of fatigue, including:
Symptoms of CFS are similar to those of most common viral infections (muscle aches, headache, and fatigue). They come on within a few hours or days and last for 6 months or more.
Physical examination may show:
A diagnosis of CFS must include:
There are no specific tests to confirm the diagnosis of CFS, although a variety of tests are usually done to rule out other possible causes of the symptoms.
There have been reports of CFS patients being found positive on the following tests:
There is currently no cure for CFS. Instead, the symptoms are treated. Many people with CFS experience depression and other psychological problems that may improve with treatment.
Overall, the best strategy for treatment includes a combination of the following:
Work with your health care provider to find a level of activity you can handle. Then gradually increase your activity level. Activity management should involve:
Relaxation and stress-reduction techniques can be helpful in managing chronic pain and fatigue. They are not useful, however, as the primary treatment for CFS. A number of relaxation techniques are available, including:
Some of the proposed treatments include:
Some medications can cause adverse reactions or side effects that are worse than the original symptoms of chronic fatigue syndrome.
Patients with CFS are encouraged to maintain active social lives. Mild physical exercise may also be helpful.
The long-term outlook for patients with CFS varies and is difficult to predict when symptoms first start. Some patients completely recover after 6 months to a year. Others may take longer for a complete recovery.
Some patients never return to their pre-illness state. Most studies report that patients who are treated in an extensive rehabilitation program are more likely to recover completely than those patients who don't seek treatment.
Call for an appointment with your health care provider if you experience persistent, severe fatigue, with or without other symptoms of this disorder. Other more serious disorders can cause similar symptoms and should be ruled out.
See also:Chronic fatigue syndrome - resources
Firestein GS, Budd RC, Harris ED Jr., et al., eds. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2008.
Engleberg NC. Chronic fatigue syndrome. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 131.