Fatigue is generally defined as the feeling of having a lack of physical or mental energy, or both. Fatigue is not to be confused with drowsiness, but the desire to sleep may accompany fatigue as it does with drowsiness. Apathy, a feeling of indifference, may also present alongside fatigue or independently. A variety of terms are often used to describe the feeling: weary, tired, exhausted, feeling malaise, run down.
What causes fatigue?
In approximately 40% of cases, a physical cause is thought to be responsible, with the other 60% thought to be caused by emotional or mental issues. Some common causes:
- Metabolic or endocrine disorders (anaemia, thyroid issues, diabetes)
- Infectious diseases (mononucleosis, hepatitis, TB, HIV, flu)
- Heart or lung conditions (heart failure, heart disease, asthma)
- Medications (antidepressants, blood pressure medications)
- Mental health conditions (depression, anxiety, grief, eating disorders)
- Sleep problems (sleep apnoea, insomnia)
Fatigue in healthy individuals is usually relieved within a few hours when physical or mental activity is reduced. Fatigue after a large meal is also a normal response, lasting from 30 minutes to several hours.
Chronic fatigue syndrome
There is one well-defined long-term condition: chronic fatigue syndrome (CFS). Broadly, there are two sets of criteria that need to be met to establish the diagnosis:
- Have severe chronic fatigue for at least six months or longer, with other known medical conditions (whose symptoms include fatigue) excluded.
- Concurrently have four or more of:
- post-exertional malaise
- impaired memory or concentration
- unrefreshing sleep
- muscle pain
- multi-joint pain without redness or swelling
- tender cervical or axillary lymph nodes
- sore throat
- headache
It is vital that practitioners and patients spend time together to determine whether the problem truly is fatigue, and if so, any associated symptoms should be explored.
Can osteopathy help?
A 1998 study at the University of Salford found a 40% improvement in patients with CFS having osteopathic treatment (the Perrin technique), compared to a 1% worsening in those not having osteopathic treatment. As the whole body is supplied by nerves exiting the spinal cord, any restriction in spinal movement can affect these nerves, which supply the limbs, internal organs, glandular and immune systems. Osteopathic treatment for CFS can include soft tissue work, articulations and mobilisations, and cranial techniques have also been useful.
A couple of complementary exercises:
- Lay on your back for 10 minutes with knees bent up and the back of your head resting on a thick book. This helps loosen the muscles around the neck (ensure that the base of the skull, where it meets the neck, is resting on the edge of the book).
- To loosen the thoracic vertebrae, sit on the edge of a chair. Place your palms by the side of your neck, shoulders relaxed and elbows pointing downwards. Turn your head and upper body slowly by 30 degrees and back, repeating 10 to 15 times. Then cross your arms in front of you so that your elbows are touching like a 'self-hug', and repeat the same slow movements.