Chronic fatigue syndrome, or CFS, is a
debilitating and complex disorder characterized by
profound fatigue that is not improved by bed rest
and that may be worsened by physical or mental
activity. Persons with CFS most often function at a
substantially lower level of activity than they were
capable of before the onset of illness. In addition
to these key defining characteristics, patients
report various nonspecific symptoms, including
weakness, muscle pain, impaired memory and/or mental
concentration, insomnia, and post-exertional fatigue
lasting more than 24 hours. I
n some cases, CFS can
persist for years. The cause or causes of CFS have
not been identified and no specific diagnostic tests
are available. Moreover, since many illnesses have
incapacitating fatigue as a symptom, care must be
taken to exclude other known and often treatable
conditions before a diagnosis of CFS is made.
in order to receive a diagnosis of chronic
fatigue syndrome, a patient must satisfy two
criteria:
-
Have severe chronic fatigue of six months or
longer duration with other known medical
conditions excluded by clinical diagnosis; and
-
Concurrently have four or more of the
following symptoms: substantial impairment in
short-term memory or concentration; sore throat;
tender lymph nodes; muscle pain; multi-joint pain
without swelling or redness; headaches of a new
type, pattern or severity; unrefreshing sleep; and
post-exertional malaise lasting more than 24
hours.
The symptoms must have persisted or recurred
during six or more consecutive months of illness and
must not have predated the fatigue.
In addition to the eight primary defining
symptoms of CFS, a number of other symptoms have
been reported by some CFS patients. The frequencies
of occurrence of these symptoms vary from 20% to 50%
among CFS patients. They include abdominal pain,
alcohol intolerance, bloating, chest pain, chronic
cough, diarrhea, dizziness, dry eyes or mouth,
earaches, irregular heartbeat, jaw pain, morning
stiffness, nausea, night sweats, psychological
problems (depression, irritability, anxiety, panic
attacks), shortness of breath, skin sensations,
tingling sensations, and weight loss.
Prevalence of CFS
Chronic fatigue syndrome (CFS) affects more than
one million people in the United States. There are
tens of millions of people with similar fatiguing
illnesses who do not fully meet the strict research
definition of CFS.
Risk Factors for CFS
-
People of every age, gender, ethnicity and
socioeconomic group can have CFS.
-
CFS affects women at four times the rate of
men.
-
Research indicates that CFS is most common in
people in their 40s and 50s.
-
Although CFS is much less common in children
than in adults, children can develop the illness,
particularly during the teen years.
-
In addition to fatigue, CFS includes eight
characteristic symptoms:
-
postexertional malaise (relapse of symptoms
after physical or mental exertion);
-
unrefreshing sleep;
-
substantial impairment in
memory/concentration;
-
muscle pain;
-
pain in multiple joints;
-
headaches of a new type, pattern or
severity;
-
sore throat; and
-
tender neck or armpit lymph nodes.
Treatment
Since there is no known cure for CFS,
treatment is aimed at symptom relief and improved
function. A combination of drug and nondrug
therapies is usually recommended. No single therapy exists that helps all CFS
patients.
Lifestyle changes, including prevention of
overexertion, reduced stress, dietary
restrictions, gentle stretching and nutritional
supplementation, are frequently recommended in
addition to drug therapies used to treat sleep,
pain and other specific symptoms.
Carefully supervised physical therapy may also
be part of treatment for CFS. However, symptoms
can be exacerbated by overly ambitious physical
activity. A very moderate approach to exercise and
activity management is recommended to avoid
overactivity and to prevent deconditioning.
Recovery from CFS
CFS affects each individual differently. Some
people with CFS remain homebound and others
improve to the point that they can resume work and
other activities, even though they continue to
experience symptoms.
Recovery rates for CFS are unclear.
Improvement rates varied from 8% to 63% in a 2005
review of published studies, with a median of 40%
of patients improving during follow-up. However,
full recovery from CFS may be rare, with an
average of only 5% to 10% sustaining total
remission.