Chronic Fatigue Syndrome (CFS) Treatment & Management

Updated: Aug 29, 2018
  • Author: Jefferson R Roberts, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Approach Considerations

CFS has no cure. Treatment is largely supportive and focuses on symptom relief. Large randomized controlled trials such as the pacing, graded activity, and cognitive behavior therapy: a randomized evaluation (PACE) trial and Cochrane reviews have recommended cognitive behavioral therapy (CBT) as an effective method for treating CFS in adults. [17, 18] However, the surveillance report in 2017 from the National Institute for Health and Care Excellence (NICE) evidence reviews recommend against CBT. [19] The Centers for Disease Control and Prevention (CDC) and the Agency for Healthcare Research and Quality (AHRQ) both have removed CBT as a recommended treatment for CFS because of insufficient evidence. [20]



No restrictive or elimination diets have been proven to be beneficial.


Exercise Therapy

Exercise is not a cure for CFS. A 2017 Cochrane review evaluated exercise therapy for patients with CFS. The study found that patients felt less fatigued following exercise therapy and felt improved in terms of sleep, physical function, and general health. However, the authors could not conclude that exercise therapy improved the outcomes of pain, quality of life, anxiety, and/or depression. [21]

The PACE trial found that graded exercise therapy (GET) effectively improved measures of fatigue and physical functioning. [17] However, updates from the NICE guideline surveillance report in 2017 recommend against GET. The CDC and AHRQ both have removed GET as a recommended treatment. [20]