But I Just Feel Too Tired To Be Fighting…

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 with fatigue or independently. A variety of terms are often used describing the feeling of fatigue, including being weary, tired, exhausted, feeling malaise and 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 cause of fatigue include:

  • metabolic or endocrine disorders (anaemia, thyroid, diabetes)

  • infectious diseases (mono, 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)

In contrast to ‘disease-related’ fatigue, fatigue occurring in healthy individuals is quickly relieved after a few hours when physical or mental activity is reduced. Fatigue can also be experienced after a large meal, which is often a normal response, lasting from 30 minutes to several hours. In addition to the feeling of fatigue, there are often many fatigue syndromes quoted in medical literature. There is, however, only one well-defined such condition, chronic fatigue syndrome (CFS).

Broadly speaking, there are two sets of criteria that need to be met to establish the diagnosis of CFS:

1. Have severe chronic fatigue for at least six months or longer with other known medical conditions (whose symptoms includes fatigue) excluded
2. Concurrently have four or more of the following:

  • 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, therefore, vital that practitioners and their patients spend time together to determine whether the problem or symptom truly is fatigue, and if so, any associated symptoms should then be explored.

Osteopathy can help with CFS, as demonstrated by a 1998 study at the University of Salford, which 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 of the body.

Osteopathic treatment for CFS can include soft tissue work (working on the tissues to relieve tension), articulations and manipulations (mobilising, stretching and manipulating the joints to relieve stiffness). Cranial osteopathy has also been found very useful in the treatment of CFS. There are also a few exercises that can be used to complement osteopathic treatment:

  • lay on your back for 10 minutes with knees bent up and the back of your head resting on a thick book. This will help 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 (upper back), there are a couple of positions, requiring you to sit on the edge of a chair before following through with the following: Position 1: place your palms by the side of your neck, with shoulders relaxed and elbows pointing downwards. Turn your head and upper body slowly by 30 degrees and back, repeating between 10 – 15 times. Position 2: cross your arms in front of you so that your elbows are touching like a ‘self-hug’. In this position, carry out the same slow movements that were carried out in Position 1.

If you suffer from fatigue or muscular/joint pain issues, or are unsure whether osteopathy can help, it may be worthwhile coming to see us at Atlas Osteopathy (with clinics in East Finchley and Moorgate, as well as the option of home visits), where we can explain your problems to you, why they occur and whether or not you are suitable for osteopathic treatment. Often this can be done via email or on the phone.