Whole body

What It Is

Chronic fatigue syndrome, also known as myalgic encephalomyelitis or ME/CFS, is a long-term condition that can affect different parts of the body. The most common symptom is extreme tiredness that makes everyday activities, like taking a shower or going to work or school, difficult (NHS, 2024a). The cause of ME/CFS is unknown. There may be periods when your symptoms get better or worse (NHS, 2024b).

There is no specific test for ME/CFS. It is diagnosed from your symptoms, after other conditions that could be causing them have been ruled out (NHS, 2024a), and the diagnosis can only be confirmed once symptoms have lasted for 3 months (National Institute for Health and Care Excellence, 2021). Because there is no test, many people find it hard to get their illness accepted and to get the support they need. When you have people who believe in your diagnosis and support you, things are easier than trying to go it alone. Finding someone you trust is important. The tiredness is real and not simply something in your head.

Understanding Chronic Fatigue Syndrome

The NHS describes 4 main symptoms of ME/CFS (NHS, 2024a)

Feeling extremely tired all the time (fatigue)
Sleep problems, such as insomnia, sleeping too much, or waking up feeling you have not slept properly, exhausted or stiff
Problems with thinking, concentration and memory (brain fog)
Symptoms getting worse after physical or mental activity, sometimes taking weeks to get better (known as post-exertional malaise)

Some people also have pain in different parts of the body, or flu-like symptoms such as a high temperature, headache and aching joints or muscles (NHS, 2024a). Because these symptoms are similar to those of other illnesses, it is important to see a family doctor or nurse practitioner to get a correct diagnosis.

ME/CFS is common: in the United States alone, up to 3.3 million people are estimated to have it. Women are affected more often than men, and it is most common in middle age, although children and teenagers can get it too (Centers for Disease Control and Prevention, 2024). Living with ME/CFS can be difficult, and it can affect your mental and emotional health and self-esteem (NHS, 2024a).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Manage Chronic Fatigue Syndrome

There is currently no cure for ME/CFS, but there are treatments that may help you manage the condition and relieve the symptoms. Your treatment plan should be tailored to you (NHS, 2024b). Alongside your healthcare team's plan, I can offer short, gentle massage to ease muscle aches, and teach breathing and relaxation techniques, always within your energy limits. See the My Approach tab for how I work.

1. Energy Management

Energy management teaches you how to make the best use of the energy you have in your day-to-day life without making your symptoms worse. You may be asked to keep a diary of your daily activities (NHS, 2024b). If you would like to increase your activity, this should be a personalised plan supported by a healthcare professional with experience of ME/CFS. Graded exercise therapy, where activity is increased by fixed amounts, is not recommended, and you should not take up vigorous unsupervised exercise, such as going to the gym or for a run, as this may make your symptoms worse (NHS, 2024b; National Institute for Health and Care Excellence, 2021).

Cognitive Behavioural Therapy (CBT)

CBT is a talking therapy that can help you manage ME/CFS and live with your symptoms. It is not a cure and does not directly treat the symptoms (National Institute for Health and Care Excellence, 2021; NHS, 2024b). If you try CBT, it is important that your CBT therapist has training and experience in ME/CFS. Counselling and other support from people you trust can also help you cope.

3. Healthy Eating

It is important to eat regularly and have a healthy, balanced diet. A dietitian with experience of ME/CFS can help if you are struggling. Diets that cut out certain types of food are not recommended, and there is not enough evidence to recommend supplements such as vitamin B12, vitamin C, magnesium or co-enzyme Q10 (NHS, 2024b). No medicine or supplement can cure ME/CFS (National Institute for Health and Care Excellence, 2021).

4. Sleep and Rest

Establishing a normal sleep pattern is important. Too much sleep does not usually improve the symptoms, and napping during the day can stop you sleeping at night. Change your sleep pattern gradually. You will probably need to rest during the day; your doctor may suggest limiting each rest period to 30 minutes and teach you relaxation techniques such as breathing exercises (NHS, 2024b). Resting completely is not recommended, as there is no evidence that it helps (NHS, 2024b).

5. Pain Relief

The NHS says painkillers you buy from a pharmacy or supermarket can help ease headaches and muscle and joint pain (NHS, 2024b). (This medicine information comes from the NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

6. Changing Your Daily Routine

People with ME/CFS usually need to adapt their daily routine and pattern of activities on a long-term basis (NHS, 2024a). Reducing stress, avoiding overexertion and building in more breaks can help. During a setback or relapse, your healthcare team can help by adding more breaks to your activities and teaching you relaxation and breathing techniques (NHS, 2024b).

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Prescription medicines for symptoms: a family doctor or nurse practitioner can prescribe stronger painkillers for short-term use, and a low-dose antidepressant called amitriptyline may be prescribed to help with muscle pain or sleep problems (NHS, 2024b).
Specialist referral: adults diagnosed with ME/CFS should be referred to an ME/CFS specialist team to confirm the diagnosis and develop a care and support plan (National Institute for Health and Care Excellence, 2021).

How I can help (see the My Approach tab)

Short, gentle massage to ease muscle aches

Breathing and relaxation techniques

Home visits when travelling would use too much energy

Tips

The causes and risk factors for ME/CFS are not clearly understood, and it can affect anyone, including children (NHS, 2024a).
Talking to other people with ME/CFS can help. The ME Association is a charity that provides information, support and practical advice (NHS, 2024a).
There is not enough evidence that complementary medicine helps ME/CFS (NHS, 2024b).
A healthy, balanced lifestyle, with activity kept within your energy limits, is an important part of managing ME/CFS.

Treatment

My Approach

With ME/CFS, the most important thing I can do is not wear you out. Your family doctor or nurse practitioner, and any ME/CFS specialist team, lead your care and your energy management plan. I fit around that plan. My aim is to ease muscle aches, stiffness and stress without leaving you drained afterwards.

Before each session I ask how your energy has been and how you felt after the last visit, and I adjust from there.

How I Work

Short, unhurried sessions with gentle, soothing massage, never deep or vigorous work
Comfortable positioning, a calm pace and easy breathing
Breathing and relaxation techniques you can use at home, including during a setback
Home visits if getting to the clinic would use too much energy, and you can email me questions between visits

Activity and Pacing

I support the energy management plan from your healthcare team rather than setting my own exercise targets
Any gentle stretching or movement stays well within your energy limits and is never increased by fixed amounts
If a session leaves you more tired over the next day or two, we make the next one shorter and gentler

If your symptoms change or get worse, check in with your family doctor or nurse practitioner.

What to Expect

Typical Course

Typical course: Visits are usually short and spaced to suit your energy, often weekly or every other week, and we space them out further or pause during a setback. ME/CFS is a long-term condition, so expect this to be ongoing support for aches and stress alongside your healthcare team's plan, rather than working towards a set recovery date.

What I Focus On

Short Gentle Sessions

Energy Management Support

Relaxation & Breathing

Flexible Visits

Sources

References

National Institute for Health and Care Excellence (2021) Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management (NG206). Available at: https://www.nice.org.uk/guidance/ng206/chapter/Recommendations (Accessed: 7 October 2026).
NHS (2024a) Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). Available at: https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/ (Accessed: 7 October 2026).
NHS (2024b) Myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) – treatment. Available at: https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/treatment/ (Accessed: 7 October 2026).
Centers for Disease Control and Prevention (2024) ME/CFS basics. Available at: https://www.cdc.gov/me-cfs/about/index.html (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooChronic Fatigue Syndrome

What It Is

Understanding Chronic Fatigue Syndrome

Self-Care & Treatment

How to Manage Chronic Fatigue Syndrome

1. Energy Management

3. Healthy Eating

4. Sleep and Rest

5. Pain Relief

6. Changing Your Daily Routine

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

How I Work

Activity and Pacing

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooChronic Fatigue Syndrome

What It Is

Understanding Chronic Fatigue Syndrome

Self-Care & Treatment

How to Manage Chronic Fatigue Syndrome

1. Energy Management

3. Healthy Eating

4. Sleep and Rest

5. Pain Relief

6. Changing Your Daily Routine

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

How I Work

Activity and Pacing

Typical Course

References

Related Conditions

Juvenile Rheumatoid Arthritis (now called Juvenile Idiopathic Arthritis)

Reactive Arthritis

Benign Hypermobility Joint Syndrome

Osteoarthritis

Book a session