What are the recommended lifestyle modifications and management strategies for patients diagnosed with chronic fatigue syndrome?

Recommended lifestyle modifications and management strategies for patients diagnosed with chronic fatigue syndrome (ME/CFS) include:

• Energy management: Patients should be supported to develop a personalised energy management plan that helps them balance activity and rest to avoid post-exertional malaise and symptom worsening. This involves recognising individual fluctuating energy limits and using a flexible, tailored approach to maintain or adjust activity levels rather than automatically increasing them. Energy management covers all types of activity including cognitive, physical, emotional, and social activities, and can take weeks to years to stabilise or improve tolerance. Healthcare professionals, especially ME/CFS specialist teams, can assist patients in recognising their limits and developing realistic goals and plans that include cognitive activity, mobility, daily living tasks, psychological and social demands, rest, sleep, and environmental factors ¹.
• Multidisciplinary specialist care: Referral to ME/CFS specialist teams is recommended, where available, to provide comprehensive assessment and support from a range of healthcare professionals such as clinicians, physiotherapists, occupational therapists, dietitians, and psychologists ¹.
• Cognitive behavioural therapy (CBT): CBT can be offered as a supportive therapy focusing on developing a shared understanding of difficulties, exploring the personal meaning of symptoms, creating and adapting self-management plans to improve functioning and quality of life, including sleep and activity management, and regularly reviewing these plans ¹.
• Managing coexisting conditions: Any coexisting or comorbid conditions should be identified and managed according to best practice guidelines, taking into account the principles of ME/CFS care and energy management ¹.
• Managing flare-ups and relapses: Patients should be informed that flare-ups and relapses can occur even when symptoms are well managed, and strategies should be in place to adjust activity and treatment accordingly ¹.

Note: There is currently no cure for ME/CFS, and management focuses on symptom control and improving quality of life through self-management and supportive care ¹.