Chronic Fatigue vs. Chronic Fatigue Syndrome

Chronic fatigue syndrome (CFS) is the name of a specific medical condition characterized by extreme and persistent fatigue. For the diagnosis of CFS to be made, certain specific criteria must be met. People with CFS and the general public often refer to the condition as "chronic fatigue." But that can be confusing. Chronic fatigue is also a symptom of many chronic conditions such as rheumatoid arthritis, fibromyalgia, and lupus. What is the difference between chronic fatigue and chronic fatigue syndrome?

An exhausted woman with her hand in her face
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What Is Fatigue?

Fatigue refers to a sensation of exhaustion during or after usual daily activities or a lack of energy to begin these activities. Most people have fatigue at one time or another in their lives. Fatigue may result from exertion, lack of sleep, or acute illnesses (such as colds). Fatigue is not extreme or persistent, in such cases. Instead, it generally goes away after getting more rest or recovering from acute illness.

What Is Chronic Fatigue?

Chronic fatigue occurs when symptoms of exhaustion or lack of energy last over 6 months. Chronic fatigue is a symptom of many chronic conditions, including rheumatoid arthritis, fibromyalgia, or lupus. Although the exact cause of chronic fatigue is unknown, certain factors can play a role, such as infection, hormone level changes, and stress.

Chronic fatigue often results from sleep disturbances, usually insomnia, in combination with chronic pain and depression. In addition, other factors that may contribute to chronic fatigue symptoms include:

  • physical inactivity and lack of exercise
  • poor diet
  • certain medications

Regardless of the cause, chronic fatigue impacts day-to-day functioning and quality of life for people with arthritis.

What Is Chronic Fatigue Syndrome (CFS)?

According to NIAMS, to have a diagnosis of chronic fatigue syndrome, a patient must have severe chronic fatigue for 6 months or longer with other known medical conditions excluded by clinical diagnosis.

At the same time, the patient must have four or more of the following symptoms:

  • substantial impairment in short-term memory or concentration
  • sore throat
  • tender lymph nodes
  • muscle pain
  • joint pain in multiple joints without swelling or redness
  • headaches of a new type, pattern, or severity
  • unrefreshing sleep
  • discomfort after physical activity that lasts more than 24 hours

The symptoms must have persisted or recurred during 6 or more consecutive months and must not have predated the fatigue. When there is no apparent explanation or cause of chronic fatigue, such as a disease, a diagnosis of chronic fatigue syndrome is given.

It should be noted a number of other conditions do overlap or often co-exist with chronic fatigue syndrome that also has similar symptoms. In fact, in one study of patients with chronic fatigue syndrome, it was found that only 38% of patients had a sole diagnosis. The others also had a diagnosis of fibromyalgia, multiple chemical sensitivity, or both. It still is not clear if these conditions or others are risk factors for chronic fatigue syndrome, are direct causes, have common causes, or have no relationship at all with chronic fatigue syndrome.

What Can Be Done

If you think you may be struggling with chronic fatigue, it is important to discuss your symptoms with your healthcare provider. Symptoms that are particularly important to discuss include:

  • anxiety
  • depression
  • insomnia with arthritis
  • pain
  • tired

It is also important to tell your healthcare provider about the medications you are taking, including dietary supplements, natural remedies, and complementary treatments. Some medications can exaggerate the symptoms listed above. For example, stimulants (such as caffeine), as well as corticosteroids, may cause sleep disturbances. Your healthcare provider can provide guidance on what medications and interventions may restore your sleep, as well as advice on medications to avoid.

It is also important to discuss chronic pain symptoms with your healthcare provider because chronic pain often leads to sleep difficulties, which in turn leads to chronic fatigue. Your healthcare provider may order laboratory tests to determine if organ involvement may be causing chronic fatigue.

For those with arthritis, maintaining a healthy weight and participating in regular exercise may also help reduce symptoms of chronic fatigue.

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  • Chronic Fatigue Research: Challenges and Opportunities, June 2003, NIAMS, National Institutes of Health

By Carol Eustice
Carol Eustice is a writer covering arthritis and chronic illness, who herself has been diagnosed with both rheumatoid arthritis and osteoarthritis.