Fatigue is a desire to rest because of exhaustion. When fatigue lasts for around six months, it is known as prolonged fatigue. Chronic fatigue is a self-reported condition lasting for at least six months. It may be persistent or relapsing. Most chronic diseases can cause fatigue, including physical and mental disorders.
Chinese medicine delineates pathological roots of a disease. Typically, such roots include, but are not limited to deficiency of any yin or yang organ (mostly of yin organs). Excess conditions, such as stagnation to the flow of qi in various organs, usually manifesting as an excess condition.
Chinese medicine's diagnosis of chronic fatigue requires distinguishing between deficiency and excess. It also needs identifying the organ(s) involved. Qi deficiency is characterised by fatigue, hyperactivity, a low voice, shortness of breath, deficient immune function, low spirits, reluctance to speak, and a pale face. The tongue is pale, and the pulse is weak and empty for such individuals.
Yang deficiency has all the above symptoms and also includes coldness symptoms, such as cold hands and feet, an increased sensitivity to cold, an aversion to cold, and possibly hypotension. The tongue is moist, because there is no heat in the body. The pulse is weak and slow.
Yin deficiency has all the symptoms of qi deficiency and warm palms.
vBlood deficiency produces blurred vision, insomnia paresthesiae, dizziness, hypotension etc.
Qi stagnation, in which distension is the cardinal symptom, is often complained of as bloating. The sight of distension varies according to the organ involved.
In Western medicine, treatment for chronic fatigue is directed to the associated medical condition. Cognitive behavioural therapy (CBT) is often the treatment of choice. Graded exercise therapy has been found to be beneficial in some cases. Somatic comorbidity, disability claims, and severe pains are associated with poor prognoses. But Chinese medicine lists various syndromes associated with fatigue. Acupuncture needles are inserted on specific acupuncture points with electro acupuncture stimulation. Acupuncture is given to patient on monthly basis, thrice a week for four weeks.
For such patients there was a 28 percent improvement in the average fatigue score immediately after the first treatment. After four treatments, the improvement was 58 percent and after 16 treatments, the improvement was 90 percent. The residual average fatigue score was 6 percent, while the individual fatigue scores for many patients came down to 0.
Acupuncture is the most effective modality of treatment for almost all cases of chronic fatigue. This is equally applicable to cases of chronic disorders, in which fatigue is a secondary symptom. Chronic disorders often need long-term treatment and concomitant use of complementary remedies.
The author is Head of the Department of Acupuncture, Sir Ganga Ram Hospital, Delhi.
This treatment is now being made available in India.