Treatments for Chronic Fatigue Syndrome

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Chronic fatigue syndrome (CFS) is an often-misunderstood disease that is only slowly being recognized as a distinct condition with specific symptoms. There are no medications approved to cure the underlying illness, but your doctor can help you manage the condition.

It’s important to tell your doctor as much as you can about your symptoms, because they vary from person to person. Typically, your healthcare provider will focus on your most severe problem first. This may be a persistent feeling of profound fatigue, slow recovery from even light activity, and a range of discomforts from confusion to a sore throat. Here’s what your doctor may recommend to help you find relief.

Good Sleep Hygiene

People with CFS often find that sleep does not leave them feeling refreshed. Good sleep hygiene, including consistent habits and surroundings that encourage restful sleep, may help. Here are some techniques that may help you sleep more soundly and wake up feeling more rested.

  • Get up and go to bed around the same time each day.

  • Arrange your bedroom to be dark, quiet and at a comfortable temperature.

  • Avoid daytime naps.

  • Use the bed only for sleep and sex.

  • Avoid caffeine, alcohol, and tobacco.

  • Take time to wind down before going to bed.

If these techniques don’t work, your doctor may prescribe sleep medication, but these drugs can have side effects or become habit-forming, so make sure you understand the risks and benefits.

Cognitive Behavioral Therapy (CBT)

CBT is a type of short-term therapy that focuses on making you aware of negative thoughts and behaviors and gives you specific ways to change them. It has been shown to be beneficial for a significant number of people with CFS, making them feel less helpless and more in control of their illness. A therapist will work with you to analyze what behaviors make you feel better or worse, and recommend techniques tailored to your individual situation and concerns. CBT can also be effective in improving the quality of sleep.

Graded Exercise and Paced Activity

Your doctor can work with you to set up a program of graded exercise, in which you slowly increase your level of physical activity. However, it is not beneficial for people with CFS to try to push through their fatigue, so pacing your daily activities is important. Don’t try to do too much on days you feel particularly tired; give yourself time to rest. Otherwise, you risk a relapse or your condition may worsen. It can be helpful to schedule your tasks carefully, so that you are not committing to more than you can comfortably handle on a given day.

Cognitive Aids

People with chronic fatigue syndrome may find they feel confused or experience other cognitive problems like memory loss or trouble recalling words. Relaxation training and meditation may help with these symptoms, and you can try using memory aids like calendars or organizers to keep you on track. Crosswords, puzzles or other brain games may help sharpen your thinking if you have the “brain fog” that can come with CFS.

Antidepressants 

Up to half of the people who have CFS develop depression at some point during their illness. If you feel sad or depressed for an extended basis, tell your doctor, who may prescribe an antidepressant. Doctors often use low-dose tricyclic antidepressants for CFS, which may alleviate the stress and anxiety that can accompany the disease. However, these drugs may have side effects and can worsen other symptoms, so be sure to tell your doctor if you notice any negative changes. Also, consider talking to a therapist who can help address your depression.

Pain Management

People with chronic fatigue syndrome may have headaches, sore throats, or aches and pains in joints and muscles. The pain can often be treated with over-the-counter (OTC) medications like ibuprofen (Advil) or acetaminophen (Tylenol). Stretching, massage, relaxation techniques, yoga and tai chi may also lessen pain and improve your sense of wellbeing. Acupuncture is another therapy that may help relieve discomfort. There are many unsubstantiated claims about pain relief for CFS, however, so if you decide to try alternative or complementary therapies, talk to your doctor about them first, because they may be ineffective or even do harm.

Treatment for Lightheadedness

People with CFS may experience lightheadedness or dizziness when they stand, even for a short period of time. This is called orthostatic instability and often occurs due to low blood volume. If you have this problem, tell your doctor about it. You may be given increased fluids and salt, and if the symptoms don’t go away, there are prescription medications you can take. Your doctor may also tell you to wear support stockings, which help circulation.

Though there is no cure for CFS, some people recover spontaneously within about six months to a year. For those who remain ill, there are effective therapies. Solid medical evidence and valid guidelines that forge effective treatments are hard to come by because CFS symptoms fluctuate. That means most doctors recommend therapies that target the most pronounced symptoms and adjust therapy based on the patient’s response to treatment. Because the symptoms are so diverse, your treatment plan may not look like someone else’s, so don’t self-diagnose or self-treat. Instead, see a provider who has experience with CFS to help you with this complex but manageable condition.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Oct 30
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

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