ME/CFS (Chronic Fatigue Syndrome): what it is and how we help

ME/CFS at a glance

Myalgic encephalomyelitis, also called chronic fatigue syndrome (ME/CFS), is a long-term condition affecting around 250,000 people in the UK. Its defining feature is post-exertional malaise: a worsening of symptoms after physical, mental or emotional effort, often delayed by a day or more. It is not the same as ordinary tiredness, and it is not caused by a lack of fitness or motivation.

Symptoms of ME/CFS

• Debilitating fatigue not relieved by rest
• Post-exertional malaise, with crashes after activity
• Unrefreshing sleep
• Problems with memory and concentration (brain fog)
• Pain, dizziness on standing, and sensitivity to light and noise

How is ME/CFS managed?

NICE guidance (NG206, 2021) recommends energy management: helping people understand their energy limits and stay within them. It advises that graded exercise therapy based on fixed increases should not be offered, and that any physical activity programme must be flexible and led by the person's symptoms. Treating symptoms such as pain and sleep problems is also important.

How we support ME/CFS in Chiswick

We follow a symptom-led, pacing-first approach and never push fixed increases in activity.

• Blood tests: to help rule out other causes of fatigue with your GP.
• Physiotherapy: gentle, flexible support for stiffness and energy management, only when appropriate for you.
• Acupuncture: some people use it for pain, sleep and relaxation.
• Manual lymphatic drainage: very gentle hands-on therapy that many people tolerate well.
• Home visits: for people whose energy makes travel difficult.

What is post-exertional malaise?

Post-exertional malaise (PEM) is a worsening of symptoms after physical, mental or emotional effort that would previously have been manageable. It usually starts hours to a day or more after the activity and can last days or longer. Recognising your personal limits and staying within them is the foundation of managing ME/CFS.

How is ME/CFS diagnosed?

There is no single test. NICE advises suspecting ME/CFS when debilitating fatigue, post-exertional malaise, unrefreshing sleep and cognitive difficulties have lasted at least six weeks in adults, and confirming the diagnosis after three months, once other causes have been ruled out with blood tests and examination. For a fuller guide to symptoms, tests and management, see what ME/CFS is.

Long COVID and ME/CFS

Some people with long COVID develop symptoms very similar to ME/CFS, including post-exertional malaise. The same principles of energy management and flexible, symptom-led activity apply. NHS post-COVID services can offer assessment and support.

What to expect at Omnia

Your first appointment is paced to your energy, with the option of a shorter session or a home visit. We talk through your symptoms, patterns of crashes and what helps, and focus on comfort, sleep and pain. Any activity we suggest is flexible and led by your symptoms, never a fixed increase, and we work alongside your GP or specialist service.

What you can do at home

• Pace: plan activity well below your limit and rest before you need to
• Break tasks into smaller parts
• Keep an activity and symptom diary to spot your limits
• Seek support from Action for ME or the ME Association

Related: fatigue. Omnia Lifestyle, Chiswick W4. Book online or call 020 4515 0000.