Chronic Fatigue Syndrome
Symptoms of Chronic Fatigue Syndrome
A patient must satisfy two criteria:
- 1) Have severe chronic fatigue of six months or more; and
- 2) Concurrently have four or more of the following symptoms: Post-exertional malaise lasting more than 24 hours. Lymphadenopathy (tender lymph nodes). Loss of concentration, (difficulty remembering), loss of short term memory. Sore achy muscles, headaches with changeable onset and severity.
Other associated symptoms of Chronic Fatigue Syndrome
- Increased heart rate upon standing (orthostatic tachycardia)
- Palpitations (irregular heart beat)
- Shortness of breath with exertion
- Cognitive (thinking and memory-related) difficulties and other neurological problems
- Disrupted sleep Pain
- Decreased blood pressure when moving from a supine to upright position (orthostatic hypotension)
- Digestive, abdominal and urinary problems
- Inability to adapt to temperature changes
- Fasciculations / muscle twitching and tingling
- Hypersensitivities to light, odours, touch, sound, foods, chemicals and medications
- Nausea, depression, panic attacks
Chronic Fatigue Syndrome
Chronic Fatigue Syndrome is characterized by lethargy with or without exertion. People with Chronic Fatigue Syndrome are only diagnosed if they meet strict criteria and therefore there are many who may have it but fall just short of pre-determined standards agreed by a best fit scenario. These pre-determined criteria and time-frames set out in a rather non-scientifically proven parameter exclude huge numbers of people in society fairly or unfairly. People of all ages, all religions, all over the world can have an equal chance of developing chronic fatigue syndrome.
The problem for medicine is that there appears to be no laboratory or scientific gold standard test that has been reliably and stringently developed to address a definitive diagnosis of Chronic Fatigue Syndrome. Society is starting to accept that there are many among us with diseases that unfortunately cannot be proven in a laboratory setting and medicine struggles to answer it. This is not the fault of medicine and there is no blame we should attach to it, medicine just hasn’t found it yet, but it will- in time.
Social morbidity and Chronic Fatigue Syndrome
The inconclusive findings for many people that don’t meet the criteria to have a diagnosis of Chronic Fatigue Syndrome does not mean that they do not have a problem or an illness. They may have another condition such as Fibromyalgia or Fabry disease. For too long Western Society has dismissed these people and some have been excluded as possible malingerers, or suffering with psychogenic pain. It is sad but now things can change. If you have or know someone with chronic fatigue syndrome, fibromyalgia or something similar and they have or have not been diagnosed then they may well have Fabry disease.
In the mean time, however it is also the job of Allied health professionals (chiropractors, physiotherapists, osteopaths) to contribute their skills in aiding medicine with our findings in routine assessments, evaluations and case studies of patients presenting to us with back or neck pain that may also have signs and symptoms of other conditions. Sharing of non-confidential information helps the evolution of medicine, contributing to the overall good of society and enriches the lives of those that may well be suffering that will subsequently benefit from our collaboration.
Allied health professionals cannot provide treatment for conditions like Fibromyalgia, Chronic Fatigue Syndrome and Fabry disease but they may potentially help those patients with treatment for back and neck pain amongst other musculoskeletal restrictions. Another part of the job of allied health professionals is to detect what they can and can’t provide treatment for and to refer on if necessary.
Main things to look for with Chronic Fatigue Syndrome
Post-exertional malaise, meaning abnormal exhaustion after any form of exertion and a worsening of other symptoms. The response may be delayed, perhaps beginning after 24 hours.
Sufferers of Chronic Fatigue Syndrome find any activity that was previously not exhausting, exhausting. To put things in perspective, people with Chronic Fatigue Syndrome would find walking a block around the local shops as tiring as a non-sufferer would find running a half marathon.
The cause of Chronic Fatigue Syndrome is unknown
Possible contributing factors that may be related include:
- Hormonal, immune and neurological responses
- Viral and other infections
- Problems with blood pressure, heart and circulation
- Digestive tract disturbances
- GeneticsBiochemical abnormalities.
The effects of this condition on a person’s life and a lack of support and recognition for what they are experiencing can lead to depression in some people with ME/CFS. However without a known cause or cure, prevention is not possible.
Where to get help and support for Chronic Fatigue Syndrome
- Local family GP
- http://www.dh.gov.uk/../../../../en/ContactUs/index.htm (UK)
- http://www.cdc.gov/../../../../cfs/ (USA)
- http://www.mecfswa.org.au/ (Australia)
If you are an Australian Citizen that has served in the armed forces, or have had a known medical condition for more than six months you also may be eligible for chronic disease management on an Enhanced Primary Care Plan (EPC). Examples can be found at here (Perth, West Australia)