The Most Effective Rated
Treatments for Chronic
Norwegian scientists surveyed 828 chronic fatigue
syndrome patients to find out what treatments were
most and least helpful.
Rest was rated the most helpful by 97% of
participants, followed by pacing at 96%.
Pacing is a method of managing energy expenditure
by limiting activities to the most essential that can
be handled at a comfortable pace.
The easiest way to understand pacing is to imagine
starting the day out with a handful of cards and each
time energy is expended, a card is lost.
When the cards are low, the day is over and sleep is
Each activity of the day requires a card, including
getting dressed, bathing, cooking, and visiting with
If too many activities exhaust the supply of cards, a
deficit ensues and one nights sleep is not enough to
Most of us start the day with unlimited cards.
Certainly we have enough to get through until
For people with chronic fatigue syndrome, they have
few cards to begin with and must pick and choose
how they expend their energy so that they don't run
out of cards and collapse.
This forces them to prioritize, establish routines,
schedule extra rest, and keep activities short. This is
known as pacing.
People with chronic fatigue syndrome also engage in
shielding, which was rated as highly helpful by 96%
of study participants.
Shielding involves surrounding oneself in quiet and,
in some cases, darkness. People with chronic fatigue
syndrome are often sensitive to light and sound,
which expends their limited supply of energy by
stimulating the central nervous system.
*Graded training may cause
deterioration of the condition
in many patients.*
One of the most misconceived treatments
recommended by the medical profession is graded
exercise therapy, yet 79% of the participants
experience deterioration as a result.
It stands to reason that with such limited energy to
expend, using too much on exercise leaves woefully
little, if any, energy for tasks of survival such as
fixing meals, eating, paying bills, and bathing.
Patients' experience is important in this context,"
says Bjorkum and colleagues, Graded training may
cause deterioration of the condition in many
Another failed treatment was cognitive behavior
therapy, yet this is also widely recommended despite
the scientific knowledge that chronic fatigue
syndrome is a serious neurological disorder which can
not simply be thought" away.
More than 4 million Americans suffer from chronic
fatigue syndrome and over 2.5% of the population
aged 18-59 years meet the diagnostic criteria. Only
20% have been properly diagnosed. Though more
frequent in women aged 40-59 years, people of all
ages, ethnicities, economic statuses, and both sexes
may be affected.
The exact cause is uncertain and likely multifactorial.
Conditions that have been proposed to trigger the
development of chronic fatigue syndrome include
viral infection, immune disorders,
hypothalamic-pituitary adrenal (HPA) axis
dysfunction, and toxic exposure.
Bjrrkum T, Wang CE, Waterloo K. [Patients'
experience with treatment of chronic fatigue
syndrome] Tidsskr Nor Laegeforen. 2009 Jun
11;129(12):1214-6. [Article in Norwegian]