Post-Exertional Malaise in Chronic Fatigue Syndrome

Another major symptom of Chronic Fatigue Syndrome is post-exertional malaise. Post-exertional malaise in CFS is defined as exacerbation of symptoms following physical or mental exertion, with symptoms typically increasing 12-48 hours after activity and lasting for days or even weeks. Post-exertional malaise and exercise intolerance, though not unique to CFS, may help to distinguish CFS from other disorders. Here is a wonderful example from my own experience.

Every year in February and July I work for one day at a toy show that my husband and I sponsor. I have to be there at about 6:00 a.m. in the morning and I am on my feet, working in the kitchen, all day until about 2:00 p.m. Usually around 10:00 a.m. I start to feel fatigued, but I press on. The day after I will be nothing but a dish rag. It usually takes me a week to recover from one day's worth of work.

Most people with Chronic Fatigue Syndrome are fatigued most or all of the time. Occasionally we may have short spans of time (lasting for several hours or days) during which we may feel better. During the times when we feel good we try to make up for lost time and end up crashing and burning. After experiencing this a few, or for some of us several times, the PWC may fear and avoid activity because personal experience has clearly demonstrated a link between exertion and symptoms. But most of us end up in an endless push-crash cycle of activity.