Physical Therapist Assistant’s Chronic Fatigue Syndrome Guide


Approximately 1% of the U.S. population is affected by the condition called chronic fatigue syndrome (CFS).  If CFS goes untreated, it can often lead to disability.  If treated properly, including physical therapy, it is possible to manage the condition well, which can result in a significant improvement in quality of life for the patient.

Physical therapist assistants should be prepared to diagnose and treat chronic fatigue syndrome in patients. This guide will discuss more information on the diagnosis and treatment of chronic fatigue syndrome by physical therapist assistants under the supervision of licensed physical therapists. More information is available on the role of physical therapist assistants at

What is Chronic Fatigue Syndrome?

This condition is categorized based on whether generalized fatigue has persisted for at least 6 months.  It is also more intense than would normally be expected based on how much effort an individual usually exerts.  Science has not been able to obtain a complete understanding of all of the underlying causes of CFS.  However, numerous researchers suspect that impairments of the gastrointestinal system, immune system and aerobic energy might cause the functional impairment that individuals who have this condition experience.

How Does CFS Feel?

Postexertional malaise is the best known CFS symptom.  This causes an individual to feel extremely tired, even with just minor overexertions or usual daily activities.  Also, individuals with CFS might have sleep disturbances, have a hard time thinking brain fog have headaches or feel generalized body pains.  Some have described CFS as feeling like having the flu that has lasted for a long time.  Over time, the symptoms might fluctuate.

It is uncommon for adults with CFS to fully recover.  However, it might be more common among children with CFS.  Current clinical management involves compensation for deficits in function and addressing symptoms to improve functioning on a daily basis.

Signs and Symptoms

Several CFS symptoms have been identified by research.  These include:

  • Fatigue.  Fatigue lasting at least 6 months is one of the main symptoms of CFS.
  • Generalized pain.  The diagnosis of fibromyalgia and CFS have a great deal of overlap.  Some studies suggest that 50-80% of individuals diagnosed with CFS qualify for a fibromyalgia diagnosis as well.  Widespread pain distributions are frequently present in both conditions.
  • Frequent headaches.  Many individuals with CFS complain that they have recurring or frequent headaches.  This can lead to physical activity being avoided.
  • Muscle weakness.  When physical activity is decreased, it can lead to general muscle weakness.
  • Confusion and cloudy thoughts.  CFS can make it hard to stay on task or concentrate.
  • Disturbed sleep.  Although they have generalized fatigue, individuals with CFS have a hard time sleeping frequently.
  • Flu-like symptoms.  Individuals with CFS report having flu-like symptoms, which includes generalized fatigue, muscle aches and sore throats.

This is a great video that explains Chronic Fatigue Syndrome and various methods of treatment:

How Is CFS Diagnosed?

Diagnosing CFS involves exclusion, which means that there aren’t any other health issues that might be causing the fatigue.  A CFS diagnosis is based on symptoms; your physical therapist or physician will base his or her diagnosis on your reported symptoms.  They might conduct medical tests as well for ruling other medical conditions out.  Unfortunately there aren’t any diagnostic tests available for confirming that CFS is present.

The first person to recognize onset of CFS might be your physical therapist due to the fact that it affects your physical functioning.  If that is the case, your physical therapist might ask you:

  • How long you have felt fatigued and when you feel fatigued.
  • If you experience any widespread discomfort or pain.
  • If you have noticed there being any significant changes in you being able to perform physical tasks.
  • If you have noticed any disturbances to your sleep.
  • If you have noticed changes recently in being able to clearly think.

Cardiopulmonary exercise testing, which includes 2 tests given 24 hours apart, might be used for characterizing how severe your functional impairment is.  Also, your physical therapist might have you fill a questionnaire out to better understand what your physical condition is, and to screen to see if any other conditions are present.

How A Physical Therapist Can Help

A physical therapist can work with you to come up with a treatment plan that will help with easing your discomfort and improving your ability to perform regular activities on a daily basis.

Because weakness, pain and fatigues all are associated with CFS, your treatment will probably focus on improving your short-term strength and endurance.  Your physical therapist might check for other kinds of conditions as well, including depression, and refer you to another specialist for co-managing your symptoms.

Physical therapy treatments might include the following:

  • Education.  Strategies will be taught to you by your physical therapist to help you with conserving energy so you can perform your daily activities.
  • Strengthening Exercises and Movement.  Exercising and moving can help to reduce your pain and improve your strength and short-term endurance.  Your physical therapist can help you with identifying specific movements that can help to reduce specific symptoms that you have.
  • Manual Therapy.  Hands-on therapy might be applied to mobilize or manipulate the soft tissues, bones and skin to help with improving movement and reducing pain.

Can The Condition Or Injury Be Prevented?

The actual underlying mechanisms of CS are unfortunately not fully understood.  As of now, there is no certain way to prevent or predict onset of CFS.  However, if the symptoms and signs that relate to CFS are detected early it can be managed.

Based on your diagnosis, your physical therapist can work with you on developing strategies in order for you to better manage and understand your symptoms or signs.

Education is key, like it is with many conditions.  When you understand maintenance strategies, like balancing periods of rest and activity, it can help you with living a functional life, despite having CFS.

Short-duration, moderate exercises might be performed without making symptoms worse once your symptoms are under control through using a self-management program.

Psychotherapy and cognitive behavioral therapy might also help with addressing potential associated disorders, like depression and anxiety.

Are you a PT or PTA that has treated chronic fatigue syndrome? Tell us about your experience in the comments below! 🙂

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