FATIGUE SYNDROME

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Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME/CFS), is a complex, long-term illness marked by disabling fatigue that does not improve with rest and often worsens after physical or mental exertion. At Singapore Paincare, our team applies the Painostic® methodology to evaluate the factors contributing to your symptoms and guide you toward a suitable, minimally invasive treatment plan.

Chronic Fatigue Syndrome

What Are the Symptoms of Chronic Fatigue Syndrome

CFS symptoms extend well beyond everyday tiredness. Most patients experience a cluster of symptoms that can last for years and significantly limit daily functioning, even though they may not “look sick” to others.

Pain

Flu-like symptoms are common, including headaches and joint pain that can come and go without warning.

Difficulty Sleeping

Sleep problems are central to CFS. Poor sleep quality compounds exhaustion, making it harder for the body to recover.

Cognitive Difficulties

Often described as “brain fog,” this includes difficulty with thinking clearly, memory lapses, and trouble sustaining attention.

Muscle Aches

Muscle pain in CFS is often a consequence of poor sleep. It can range from dull aches to tightness and pulling sensations and may shift from one part of the body to another, resulting in generalised body pain.

Associated Symptoms

Other symptoms reported by CFS patients include irritable bowel, bloating, constipation, diarrhoea, night sweats, chills, mood swings, irritability, anxiety, vision problems, and tingling or numbness in the hands, feet, or face.

Important: CFS symptoms can persist for years and result in serious disability. If your fatigue has lasted more than a few weeks and is not improving with rest, a pain specialist assessment can help identify what is driving it.

What Causes Chronic Fatigue Syndrome?

The exact cause of chronic fatigue syndrome has not yet been established. What research has shown is that CFS is more likely to affect women than men, and it is far more common in adults than in children.

Ongoing research points to several factors that may contribute to the onset of CFS, although no single cause has been confirmed:

Potential Contributing Factor What Current Research Shows
Post-viral trigger Some people develop CFS-like illness after an infection, including Epstein-Barr virus and, more recently, COVID-19 (often referred to as Long COVID).
Immune system changes Some patients show altered immune responses, including reduced natural killer cell activity, which may contribute to symptom severity.
Hormonal and stress-response changes Some people with CFS have differences in cortisol patterns linked to the body’s stress-response system, which may influence fatigue and inflammation.
Family history CFS has been observed to occur more frequently within some families, suggesting a possible genetic or shared environmental influence.

How Is Chronic Fatigue Syndrome Diagnosed in Singapore?

There is no single test that confirms chronic fatigue syndrome. At Singapore Paincare, our team of experienced primary care doctors and pain care specialists, together with a rheumatologist, will evaluate your condition through:

  • A physical examination
  • A mental evaluation
  • Detailed questions about your symptoms, including onset, duration, and pattern of fatigue
  • A review of your medical history

Additional tests, such as blood or urine tests, may be requested to check for infection and to rule out other illnesses that can cause similar symptoms. Because CFS has no specific diagnostic marker, this process of ruling out other explanations is a standard and necessary part of reaching an accurate diagnosis.

What Are the Treatment Options for Chronic Fatigue Syndrome?

There is no single test that confirms chronic fatigue syndrome. At Singapore Paincare, our team of experienced primary care doctors and pain care specialists, together with a rheumatologist, will evaluate your condition through:

  • A physical examination
  • A mental evaluation
  • Detailed questions about your symptoms, including onset, duration, and pattern of fatigue
  • A review of your medical history

Additional tests, such as blood or urine tests, may be requested to check for infection and to rule out other illnesses that can cause similar symptoms. Because CFS has no specific diagnostic marker, this process of ruling out other explanations is a standard and necessary part of reaching an accurate diagnosis.

Non-Surgical Treatment

Cognitive Behavioural Therapy

Our specialists offer cognitive behavioural therapy, which treats the condition through planning and recognition techniques to help patients manage symptoms and daily activity levels.

Pharmacotherapy

Our specialists offer medications to help patients manage sleep and other symptoms. Medications may be used to improve sleep architecture without relying on sleeping pills, which often do not help CFS sufferers.

Coreflex Injections

Coreflex injection uses a mix of local anaesthetic, anti-inflammatory, and muscle relaxant to help break the pain cycle, reduce inflammation, and support healing.

PRP Injections

PRP injection is more suitable for chronic painful back or joints. The platelet-rich plasma improves blood supply to the injured area, increasing fibroblastic activity and supporting the scarring and healing of injured soft tissue.

Exercise Therapy

Our specialists can guide a personalised, graduated exercise plan to help combat fatigue and improve strength and endurance, paced appropriately so it does not worsen symptoms.

Surgical Treatment

There are currently no surgical treatments for chronic fatigue syndrome.

Who Is Most at Risk of Chronic Fatigue Syndrome?

CFS does not affect everyone equally. Based on available population data:

Risk Factor Key Findings
Sex Women are affected substantially more often than men. US national health data (2021–2022) found 1.7% of women had ME/CFS, while prevalence was lower in men. Other studies estimate women are affected 3–5 times more often than men.
Age ME/CFS is far more common in adults than in children. US data shows prevalence increasing from 0.7% among adults aged 18–39 to approximately 2.0–2.1% among those aged 50–69.
Overall prevalence An estimated 1.3% of US adults (around 3.3 million people) had ME/CFS in 2021–2022. Studies from parts of Asia, including Japan and Korea, report prevalence ranging from approximately 0.76% to 1.31%.

How Can I Prevent Chronic Fatigue Syndrome?

There is currently no known way to prevent chronic fatigue syndrome.

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Frequently Asked Questions 

Chronic fatigue syndrome, also called myalgic encephalomyelitis (ME/CFS), is a long-term illness causing disabling fatigue that does not improve with rest. It is often accompanied by sleep problems, muscle pain, and cognitive difficulties, and symptoms can last for years.

Ordinary tiredness improves with rest and sleep. CFS-related fatigue does not, and it can worsen after physical or mental exertion. Many patients cannot function the way they did before, even though they may not look unwell.

The exact cause is not yet known. It is more common in women than men and more common in adults than children. Research suggests possible contributing factors, including infections, immune system changes, and hormonal or stress-response differences, though no single cause has been confirmed.

Yes. There are currently no surgical treatments for CFS. Management options include cognitive behavioural therapy, pharmacotherapy to support sleep and symptom control, Coreflex or Myospan (PRP) injections for muscle pain, and personalised exercise therapy.

Women are affected more often than men, and adults are affected far more often than children. Prevalence also appears to rise with age.

There is currently no known way to prevent chronic fatigue syndrome. Treatment focuses on managing symptoms, such as pain and sleep disturbance, through a combination of therapies tailored to the individual.

Related Pain Conditions

CFS shares overlapping symptoms with, and is sometimes associated with, the following conditions also treated at Singapore Paincare: