Part 3: Natural Approach to Treating Chronic Fatigue Syndrome/Myalgic Encephalomyelitis and Fibromya
We've finally made it to the best part: treatment strategies!
As you may recall from Part 1 (read here), many patients who meet the diagnostic criteria for CFS/ME have a component of pain that meets the criteria for FM. They are co-morbid syndromes often occurring together with major overlapping in symptoms, so for that reason, I'm coupling the treatment approach together. In practice, my treatment plans are patient-centred depending on individual obstacles to health, bothersome symptoms, etc. but this post gives an overview of my approach using Naturopathic Medicine.
Before diving in, I want to make one point clear: Generally, a multi-disciplinary approach to treatment works best. I am not anti-medication. Some patients get a lot of relief from certain medications and that's great! Naturopathic Medicine can address symptoms that aren't being addressed with medication and/or can help reduce side effects.
Prognosis - "Will I ever get better?"
A review of 14 studies (from 2005) looked at ME/CFS patients and found that:
5% - recovered
40% - improved during follow-up
8-30% - returned to work
5-20% - had worsening of symptoms
Most patients aren't able to return to their pre-illness level of functioning. But take the above stats with a grain of salt - each of those studies had different inclusion criteria for patients studied, used different questionnaires to determine recovery, and patients were receiving different treatments.
When looking at those CFS/ME patients with a decreased likelihood of improvement, they found the following risk factors:
-Severity of illness at time of onset
-Lack of early management (overexertion in the early stages are more likely to lead to deterioration) *see below on pacing*
-Having a mother with the illness
-Co-morbid diagnosis of fibromyalgia
Fundamentals to Treatment
1. Pacing = most important for CFS/ME patients
Pacing is conserving energy by taking breaks in between activities to avoid 'crashes' from over-exertion. These breaks can involve lying down, meditating, deep breathing, or simply sitting down. This can be extremely difficult for patients to do because of pressure (put on themselves or by others) to maintain normal functioning like keeping up with chores, cooking, looking after kids, going to work, etc. I