Chronic fatigue syndrome (CFS) is a medical condition, in which the person suffers from extreme fatigue, and tiredness, accompanied by other symptoms that are present for six months or more. Fatigue gets aggravated by physical or mental activity that does not improve with rest. Though there is no complete cure for CFS, patients with medical conditions associated with CFS are given proper medical care, with physiotherapy. Physiotherapy is one of the most effective treatments used for chronic fatigue syndrome. Your physiotherapist will provide you with a mild exercise program. In this blog, we will discuss chronic fatigue syndrome and its physiotherapy treatment.

Chronic Fatigue Syndrome (CFS)
Chronic Fatigue Syndrome is usually sudden and often accompanied by symptoms like chronic, severe, mental and physical exhaustion, sore throat, short-term memory loss, tenderness, muscle weakness, muscle or joint pain, headache, digestive disturbances, respiratory and cardiac problems, increased sensitivity to light, smell, and sound, chemical sensitivity, depression, etc. This condition may have poorly understood multiple causes like biological, genetic, infectious, environmental, and psychological. Whereas genetic predisposition, viral or bacterial infection, immune dysfunction, toxic chemical exposure, severe stress, vaccinations, etc. may also be the reason for its occurrence.

Physiotherapy management
The physiotherapist recommends a simple range of motion and stretching exercise for a few minutes per day for totally inactive patients. These exercises are slowly progressed by increasing the intensity, thus helping in decreasing the sensitivity towards the exercises.

Exercise therapy
Exercise therapy helps to improve chronic fatigue as it allows the patient to build up tolerance and endurance for everyday tasks.  The physiotherapist assesses the patient and recommends a graded exercise program.  Exercise therapy helps to build strength and endurance. Exercise maximizes adherence, and develops muscle memory and confidence of the patient these exercises include, squats, calf raises, step-ups, etc. Once the patient's strength is improved, a more weighted or structured exercise program is recommended to build strength and endurance. In-between a complete track of the patient's exercises are kept to make sure they achieve the desired result.

Relaxation exercise
Relaxation exercises focus on breathing fresh air with musical aerobic exercises, it is an effective way to boost the motivational factor. It increases endurance, increases dopamine levels, which in turn improves focus and motivation, thus the levels of the stress-related hormone cortisol will also decrease.

Manual therapy
Manual therapy techniques help to reduce discomfort, and musculoskeletal or nerve irritation, and once their strain is at a minimum, the physiotherapist starts an endurance and strength program.

Start Slow
The patient can start by doing some basic household chores for 15 to 30 minutes followed by, rest intervals which are essential to prevent mental or physical exertion that may contribute to crashing. Also, positions such as spending too much time standing or even sitting upright can cause crashing. Whereas, just lying down all the time may also make it harder to tolerate being upright, gradually incorporate workouts into the schedule, three times a week.

Gentle, Low-Impact Exercises
Gentle and low-impact exercises like walking, stretching, and pilates are recommended. The exercises are started slowly and gradually to build up strength.

Perform Exercises (Sitting Down or Leaning Back)
Exercises should be performed while in a seated or leaning position. By sitting or reclining, they reduce the strain from reduced blood flow so that their bodies can better tolerate exercise. Depending on the person's exercise tolerance start exercising with a recumbent bike or stationary pedals. Pedaling on a recumbent bike should be done for 5 minutes with very low resistance. For the upper body, weight lifting can be cooperated like using (1- 2 pounds) dumbbells, doing 1 set, and repeating a few times. For stationary, pedals sit on a chair or lie on the floor while pedaling. The physiotherapist recommends a simple walk in a park without fatigue for 5 minutes or jogging without fatigue, skipping, etc.

If the patient feels exertion while doing the exercises then he/she should stop immediately to avoid the risk of worsening the symptoms.