Do you feel exhausted?

Chronic Fatigue can appear in many conditions 

Chronic diseases and chronic fatigue


In recent years, researchers have begun to watch in more detail the symptom of fatigue, which exists frequently in chronic conditions and has a negative impact on the functionality and quality of one's life. Fatigued is believed to be multidimensional in nature and factors that contribute to its appearance include muscle weakness, pain, anxiety and disturbed sleep [1]. Some chronic conditions, in which fatigue appears, beyond Chronic Fatigue Syndrome, are described below:

Cancer and chronic fatigue


Chronic fatigue is one of the major symptoms occurring in patients with cancer [2,3] and it has been found to be the most common marker that affects the quality of life of the person living with cancer [4]. Exercise improves fitness in people with cancer [5,6], their general health [5], reduces fatigue [7] as well as depression [5,7] and increases happiness [5].



Stroke and chronic fatigue


Fatigue after a stroke is a common symptom, which may persist long after the episode. [8] It can appear to up to 70% of patients [8,9], but often remains "invisible". This symptom is not the same as that of tiredness, because frequently it appears without warning and it does not leave with rest. Factors affecting fatigue are muscle weakness, sleep, pain, medication, depression and difficulty in speaking [8.10]. Fatigue in turn can adversely affect life expectancy [11].



Multiple sclerosis and chronic fatigue


Fatigue is the most common and one of the most debilitating symptoms in multiple sclerosis (MS) [12,13]. Although the onset of fatigue in MS is not fully understood, it is thought to be multifactorial and to be affected by changes in the immune and nervous systems, sleep problems, changes in the circadian rhythm and depression [14].



Rheumatoid arthritis and chronic fatigue


Patients with rheumatoid arthritis often have fatigue, which as they state upsets them and creates anxiety and has a significant negative impact on their lives. They cite that they cannot manage fatigue and they do not have enough support from health professionals who believe that they cannot deal with it and as such leave the patient to cope alone [15].



Fibromyalgia and chronic fatigue


Often patients with fibromyalgia have severe fatigue, which reduces their motivation to do activities, extends the time of the activity, hinders concentration and memory [16] thus affecting their lives.



  1. Connolly  et al. Managing fatigue in patients with chronic conditions in primary care. Family Practice, 2013;30:123–124.

  2. Orre et al. Chronic cancer-related fatigue in long-term survivors of testicular cancer. Journal of Psychosomatic Research, 2008;64: 363–371.

  3. Prue et al. Fatigue in Gynecological Cancer Patients During and After Anticancer Treatment. Journal of Pain and Symptom Management, 2010; 39(2): 197-210.

  4. McCabe et al. (2015) Fatigue as a Driver of Overall Quality of Life in Cancer Patients. PLoS ONE 2015;10(6):e0130023.

  5. Courneya et al. Randomized Controlled Trial of the Effects of Aerobic Exercise on Physical Functioning and Quality of Life in Lymphoma Patients. J Clinical Oncology;2009:27(27): 4605-1.

  6. May et al. Improved physical fitness of cancer survivors: A randomised controlled trial comparing physical training with physical and cognitive-behavioural training. Acta Oncologica, 2008;47(5):825-834.

  7. Sprod et al. Three versus six months of exercise training in breast cancer survivors. Breast Cancer Res Treat (2010) 121:413–419.

  8. Glader et al. Poststroke Fatigue A 2-Year Follow-Up Study of Stroke Patients in Sweden. Stroke, 2002;33:1327-1333.

  9. Leegard. Diffuse cerebral symtoms in convalescents from cerebral infarction and myocardial infarction. Acta Neurol Scand, 1983;67:348–355.

  10. Ponchel et al. Factors Associated with Poststroke Fatigue: A Systematic Review. Stroke Research and Treatment, 2015;Article ID 347920.

  11. Mead et al. Fatigue after Stroke: Baseline Predictors and Influence on Survival. Analysis of Data from UK Patients Recruited in the International Stroke Trial. PLoS ONE, 2011 6(3):e16988.

  12. Braley et al. Fatigue in Multiple Sclerosis: Mechanisms, Evaluation, and Treatment. SLEEP, 2010;33(8):1061–106.

  13. Heine et al. Exercise therapy for fatigue in multiple sclerosis. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No.: CD009956.

  14. Braley et al. Fatigue in Multiple Sclerosis: Mechanisms, Evaluation, and Treatment. SLEEP, 2010;33(8):1061–1067.

  15. Hewlett et al. Patients' perceptions of fatigue in rheumatoid arthritis: overwhelming, uncontrollable, ignored. Arthritis Rheum, 2005;53(5):697-702.

  16. Humphrey et al. Fatigue in fibromyalgia: a conceptual model informed by patient interviews. Musculoskeletal Disorders, 2010;11:216.