An obese woman in her thirties with a history of fibromyalgia syndrome, depression, polycystic ovarian syndrome, and diabetes mellitus presents to her local emergency department with 1 week of gradually worsening midline back pain.
A 34-year-old woman presents with the sole complaint of fatigue that has grown gradually worse over 6 months. She attributes a recent 5-lb weight gain to her lack of energy to exercise. No family members share her symptoms. She is newly in remission (8 months) from Hodgkin disease and is generally happy.
The treatment of chronic fatigue syndrome (CFS) is mainly supportive. The key to effective management is to establish a therapeutic alliance with patients and to convey a consistent message that their complaints are taken seriously. Although spontaneous recovery is rare, it does occur in some patients with CFS.
Chronic fatigue syndrome (CFS) is a distinct disorder characterized by debilitating and often recurrent fatigue that lasts at least 6 months but more frequently lasts for longer periods. Patients with CFS experience overall physical, social, and mental impairments and may subsequently qualify for medical disability.
A study of Humana members enrolled in commercial and Medicare Advantage plans showed that patients with fibromyalgia have higher health care utilization and costs than those without the disease.1 This is because of higher use of office visits, testing, and procedures as well as pain-related medications.