Who treats chronic fatigue syndrome?
Since there is no specific treatment protocol recommended for chronic fatigue syndrome, there isn’t a single doctor involved in managing CFS/ME patients. However, a psychiatrist, CFS clinic, as well as a physiotherapist have a very important role to play in this.
You’d be surprised to know why there are a number of health professionals involved in CFS/ME ?
To understand this, it is very important for us to go into the details of the disease mechanism itself and how the signs and symptoms lead a patient to seeing different specialty doctors one after the other.
Chronic fatigue syndrome (CFS) is a chronic illness with a wide range of signs and symptoms. The most common of which is extreme fatigue, followed by muscle aches . CFS is also known as ME, which stands for myalgic encephalomyelitis.
CFS/ME is more common in women than men. However, it is not uncommon for young children to be affected with this syndrome, and surprisingly, young patients’ prognosis is far better than the older ones.
Common symptoms :
- Muscle aches
- Joint pain
The diagnosis usually needs a lengthy time to be established because CFS is a diagnosis of exclusion. This means that all other possible conditions where fatigue is the overlapping component, have to be ruled out first. In the meantime, patients tend to visit different doctors because of the symptoms they experience. For example, while visiting an internal medicine doctor initially, apart from general fatigue symptoms, lack of sleep will tempt a patient to visit a psychiatrist. Similarly, debilitating joint pain will possibly make him visit a rheumatologist . However, once the diagnosis is confirmed, a psychiatrist as well as a physiotherapist play a major role in managing a patient since the mainstay of treatment is CBT, which stands for Cognitive Behavioural Therapy.
CBT has been proven to be a game changer in a majority of patients where it helps them to deal with the triggers and to gradually resume their everyday activities. In addition, concomitant physiotherapy has been well acknowledged, involving stretching and relaxing exercises which are individualized according to the severity of signs and symptoms. The combination of both these treatment strategies has been proven to be very effective. The drawback is a response which is usually noticed at least after a few weeks to months. Quite understandably, it is very difficult for them to wait under these circumstances where they have been suffering on a minute-to-minute basis, and they tend to move to the facilities in an effort to have a prompt treatment response.
Multiple symptoms appearing simultaneously is another reason. For example, if a patient experiences joint pain, they would rather prefer to attend a rheumatologist clinic, and other symptoms mislead patients in a similar fashion, such as consulting a cardiologist for palpitation which is also a common symptom in CFS.
This leads us to the conclusion that after being given a confirmed diagnosis initially by your GP, where he rules out all the possible health conditions by carrying out relevant investigations, a referral is made to the CFS clinic or to a psychiatrist. And the mainstay of treatment remains cognitive behavioural therapy. If necessary, a physiotherapist is involved in remedying the situation.
Despite all this, it is extremely important for a patient to remain compliant all along their therapy, otherwise CBT would be ineffective and the role of CFS clinic and a psychiatrist will be very limited. It is also very important for you to remain active and strong throughout this journey. Multiple exercises could be regularly done such as hand stretches, sitting and standing, wall push ups, picking up and grasping objects. These can be carried out at home and can be divided into brief sessions to be done on a day-to-day basis.
This is how a multidisciplinary approach is of great importance when it comes to managing CFS/ME patients.