Myalgic Encephalomyelitis / Chronic Fatigue Syndrome and Long COVID

Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) is often under diagnosed by clinicians. This condition, similar to Irritable bowel syndrome and fibromyalgia, this condition does not have any specific images or lab work that help clinician’s diagnosis. However, the CDC estimates 836,000 to 2.5 million Americans suffer from ME/CFS. This issue is characterized b the below symptoms without any other known cause.

Postexertional malaise (PEM) is characterized by severe fatigue that occurs after mental or physical stressors. This is a strong characteristic of this syndrome. Unlike fibromyalgia in which increasing exercise and movement helps decrease symptoms, those with ME/CFS usually have worsening symptoms and are often followed by an episode of “crashing” which may lead to being bed bound for a day or more. There is some thought that there is an association with developing ME/CFS after previous history of infectious diseases including Lyme’s disease, infectious mononucleosis “mono”, and more recently long COVID.

As you may notice when reflecting on the multi-system effects of ME/CFS and Long COVID in the above two diagrams, the Osteopathic Approach to understanding some of these complex illnesses is particularly suited for understanding and treating patients with this syndrome. (See previous articles on The Biomechanical Model, The Metabolic Nutritional Model, The Behavioral/Biopsychosocial Model, and The Bioenergetic Model).

Interestingly, treatment approaches as available both through the CDC and the ME/CFS Crash Survival Guide available through Salt Lake City’s Bateman Horne Center recommend a Holistic Approach to treatment including appropriate nutrition, sleep, “pacing” exertional and stressful activities, stress/anxiety management, “trigger” avoidance, rescue medications, and pain management (such as body work through and Osteopathic Physician).

I think the complex nature of this illness makes Osteopaths well suited to identify and promote holistic treatment plans for this little-understood but common ailment. Using the Osteopathic approach to treating trauma provides a promising future for this group of patients. If you or someone you know is suffering from chronic fatigue >6 months without known medical cause and have significant Post Exertional Malaise as defined above, I heavily encourage you to review the Crash Survival Guide and consider finding a holistic-minded healthcare practitioner to be your advocate and provide validation for you symptoms.

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