Treatment: Supportive Therapy
With no known cause or cure for chronic fatigue syndrome (CFS), treatment is based on relieving
symptoms and, more specifically, the severity of symptoms. Treatment options are supportive in nature in that they can provide a measure of comfort and symptom relief without the use of medications.
A candid conversation between the primary treating physician and the person with CFS (PWC) is essential to finding therapies that may prove helpful.
Supportive, symptomatic therapy is individualized. The following dimensions should be considered as treatment is planned: the PWC's medical, social and financial resources; general physical, mental and emotional health status; personal preference and individual
Therapies to help PWCs maintain some level of flexibility and muscle tone may be needed to relieve pain and reverse deconditioning that may have occurred. There are conflicting opinions on the benefits of exercise because of the resulting relapses and fatigue that PWCs often experience. A physical therapist or exercise physiologist, together with the PWC, can develop a personalized plan that maximizes the capabilities of the
PWC while ensuring that symptoms are not exacerbated by too vigorous exercise. Generally, the PWC begins very slowly (1-2 minutes of gentle stretching each day for a week) and gradually increases activity level (add one minute each week, as tolerated.) Even severely affected PWC's may benefit from an activity plan that is individualized to their situation.
CFS can have a profound effect on a PWC's ability to work. The inability to perform on the job may require minor adjustments for those with mild symptoms, while those with more severe symptoms may be unable to work at all. An occupational therapist can assess the PWC who remains on the job and recommend approaches to help utilize energy more efficiently. Disabled PWCs who are considering a return to work or need to develop energy-saving strategies may also benefit from a consultation with an occupational therapist.
A well balanced diet provides a healthy foundation for everyone. The American Dietetic
Association's food pyramid guidelines are designed to promote good nutrition. PWCs who have allergies, digestive disorders, and other food-related problems may wish to visit a registered dietitian who can outline nutritional needs (and necessary supplements), determine substitutes for problem-causing foods that have been eliminated from the diet and provide tips for meal planning and preparation that help conserve energy.
Several dietary and herbal supplements are reported to have immune- and energy-boosting properties and some PWCs have experienced symptom improvement when taking these products. Using common sense to ensure safety when taking these supplements is important. The primary treating physician needs to be informed of any supplement use to avoid the possibility of interactions with medications being taken, as well as to help track response to therapy. PWCs need to be alert to products that come with outlandish promises and "magical cures" and thoroughly investigate these product claims before purchasing and using the product.
Unrefreshing sleep is a much-reported symptom and is one of eight symptoms in the. Sleep management techniques may help PWCs. Sleep studies can be done to identify any primary sleep disorders to rule out an underlying physiological cause for sleep disturbances such as sleep apnea. Sleep centers can also assist PWCs with various sleep management techniques. In addition, PWCs need to be alert to the possibility that some medications and supplements may interfere with sleep.
Mental Health Counseling
Anxiety and depression are potential effects of CFS as PWCs strive to cope with the life-altering changes that occur with a chronic illness. The primary treating physician may conduct a brief mental health evaluation and, if necessary, make a referral to a mental health professional who can conduct a more in-depth assesment and assist the PWCin makingpositive adjustments.
Cognitive Behavioral Therapy (CBT)
This form of therapy combines cognitive therapy with behavioral therapy and focuses on the person's thoughts, assumptions, beliefs and habitual
reaction to these thoughts and beliefs. During CBT, PWCs learn methods to help re-direct thinking processes and take steps to modify their reactions.
Relaxation techniques, such as deep breathing or meditation, are often utilized in CBT. There is evidence that this therapy has helped some PWCs cope better with the effects of a chronic, unpredictable illness, although it doesn't offer a cure.
In addition to the modalities suggested above, complementary therapies, such as acupuncture, yoga and tai chi can offer some benefit. Overall, it's important to remember that responses vary: what works for some people does not work for others. PWCs often try multiple diverse treatments for symptom relief. PWCs who are aware of treatment options and are willing to frankly discuss these with their primary treating physician will likely have greater opportunities for symptom management.
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