Chronic fatigue syndrome

Chronic fatigue syndrome (CFS) is an illness characterised by persistent medically unexplained fatigue of more than six months duration without any muscle weakness (Merck 2012). Sufferers experience significant disability and distress, which is often exasperated by lack of understanding from others. Other symptoms reported include musculoskeletal
pain, sleep disturbance, impairment in short term memory and concentration and headaches

Another name for CFS is myalgic encephalomyelitis, otherwise known as ME. Here the name literally means muscle pain and inflammation of the brain and spinal chord. CFS typically affects 250,000 people in the uk (NHS Evidence, 2011).

Symptoms of CFS can range from mild; where you are able to care for yourself, to very severe where you are unable to carryout daily tasks where bed rest is often required.


The exact cause of CFS is not fully understood. Although associations have been proposed between a previous encounter with a virus, allergies.

Immunological abnormalities have also been noted, but it is unclear whether this is due to the result of CFS or the cause. Other links have included neuroendocrine and neurotransmitter abnormalities, genetic predispositions, emotional/physical trauma

Luis et al (2012) has proposed that the autonomic nervous system may play a role in CFS given the numerous autonomic signs and symptoms such as such as orthostatic symptoms and tachycardia, increased sweating, pallor, sluggish pupillary responses, gastrointestinal symptoms, and frequency micturition. This of particular interest given that acupuncture has be shown regulate the autonomic nervous system.  Luis et al explains that strong links have also been identified between hemodynamic mechanisms underlying the autonomic responses and how they may play a role in the pathophysiology of CFS and its symptoms.

Conventional treatments

There is no known pharmacological treatment or cure for CFS (NICE guidelines, 2007) however some drugs may be used to mange signs and symptoms. Other recommendations include sleep management advice, advice on resting and relaxation techniques and dietary advice

How can Acupuncture help?


Zhongguo Zhen Jiu. 2012 Mar;32(3):205-8.Observation on therapeutic effect of chronic fatigue syndrome treated with coiling dragon needling and moving cupping on back.Xu W, Zhou RH, Li L, Jiang MW.


The therapeutic effect of chronic fatigue syndrome treated with coiling dragon needling and moving cupping on back is positive, superior to that of Prednisone with oral administration.

 Zhen Ci Yan Jiu. 2011 Dec;36(6):437-41, 448.Observation on therapeutic effect of acupuncture of Back-shu acupoints for chronic fatigue syndrome patients

Zhang W, Liu ZS, Xu HR, Liu YS.

Acupuncture at Back-shu point has a good therapeutic effect (including immediate and midterm effect) in the treatment of chronic fatigue syndrome patients.
 Zhongguo Zhen Jiu. 2010 Jul;30(7):533-6.Randomized controlled study on acupuncture treatment for chronic fatigue syndrome

Chen XH, Li LQ, Zhang W, Yang J, Dai YS, Xu DH, Tang CZ.

Both of the acpuncture treatment and Shenmai injection are able to decrease fatigue scale score, improve the fatigue symptoms of CFS patients, and the effect of acupucture treatment is obviously superior to that of Shenmai injection.
Zhongguo Zhen Jiu. 2010 Apr;30(4):309-12.Effect of electroacupuncture at Shenshu (BL 23) and Zusanli (ST 36) on the event-related potentials of chronic fatigue syndrome

Cheng CS, Zhu YH, Liang FR, Wu X, Jin SG, Wu FP.

The event-related potential circadian rhythms are lost in CFS patients. Electroacupuncture at Shenshu (BL 23) and Zusanli (ST 36) can regulate the circadian rhythm of P3a and P3b latency and improve the cognition of the patients in daytime.


How can osteopathy help?


J Chronic Fatigue Syndr 1997, 3:43-51.Massage therapy effects on depression and somatic symptoms
in chronic fatigue syndrome.

Field TM, Sunshine W, Hernandez-Reif M, Quintino O, Schanberg S, Kuhn C,
Burman I

Depression, anxiety, and pain not only decreased immediately after receiving the 1st massage, but continued to decrease over the 5-wk treatment period. MT helped alleviate not only fatigue symptoms but other somatic symptoms associated with CFS.


Luis et al (2012). Primer on the Autonomic Nervous System . 3rd ed. New York: Academic Press. 531–534.

NHS, Evidence . (2012). Chronic Fatigue Syndrome: Introductio. Available: Last accessed 8th Jan 2013.

Porter et al (2012). The Merck Manual: professional edition. 19th ed. USA: Merck Sharp & Dohme Corp.