Friday Q&A: Chronic Fatigue Syndrome, Part 2

Road by Melina Meza

Q: I find that there are not many yoga teachers with an awareness of yoga practice specifically for Chronic Fatigue Syndrome (CFS). I was diagnosed with CFS 6 months ago and am doing graded exercise therapy, which includes walking. I would love to practice yoga every day, but am lost as to where to begin. Any help would be much appreciated!

A: We received this follow-up inquiry recently from one our readers following an earlier post I did on CFS. Just so everyone out there reading this is on the same page, start by checking out my Nov 5th blog post Chronic Fatigue Syndrome and Yoga.

Now I’ll recap by giving you the Mayo Clinic’s LINK list of CFS symptoms:

“Chronic fatigue syndrome has eight official symptoms, plus the central symptom that gives the condition its name:

•    Fatigue
•    Loss of memory or concentration
•    Sore throat
•    Enlarged lymph nodes in your neck or armpits
•    Unexplained muscle pain
•    Pain that moves from one joint to another without swelling or redness
•    Headache of a new type, pattern or severity
•    Unrefreshing sleep
•    Extreme exhaustion lasting more than 24 hours after physical or mental exercise

And to meet the diagnostic criteria of chronic fatigue syndrome, you must have unexplained, persistent fatigue for six months or more, along with at least four of the above signs and symptoms”

Next, I’ll recap what the folks at the Mayo Clinic have to say about CFS, and explain how I think yoga fits in (in italics):

1. CFS is a condition that does not improve with rest, so gentle yoga movements could help. 
2. Even though the cause is not known, it is theorized that stress may play a role, and yoga is great at reducing the effects of stress.
3. Because the fatigue may worsen with physical or mental activity, a yoga practice for CFS should have several types of practices to take into account the variability of symptoms from day to day.  More on this in a moment!

In addition, I recommend that you read the posts we have done here at YFHA on yoga for pain, yoga for insomnia, and yoga for headaches to get some additional ideas on how to address those symptoms of CFS.

Because our reader mentioned that she has been prescribed “graded exercise therapy,” meaning that the type and intensity of her exercise is slowly and gradually increased, usually in response to how she would be doing from day to day, I would add that such an approach would also have practices that could step things back and down if flares occur. This day-by-day approach to things like walking could be extended to yoga practices as well. And although I mentioned some of these ideas back on Chronic Fatigue Syndrome and Yoga, I am presenting them in a slightly different way today.

On a day when mental fatigue is an issue, longer supported restorative poses would be a good choice, with the easiest of mental focuses, such as simply following your inhales and exhales. A supported Savasana with a recorded yoga nidra might also be appropriate on these days. Remember, conscious relaxation for 10 minutes or for longer times, as in yoga nidra, can provide a different kind of “rest” than typical sleep or napping, which could be beneficial for both physical and mental fatigue.

When increased pain is occurring, gentle yoga practices or restorative practices that don’t aggravate or increase the pain levels while they are being done could keep the body moving and active. The more intense the pain, the more likely restorative poses with a meditation on breath or mantra—so as to remove the “thinking about pain” from the actual experience of pain—should be employed.

As fatigue lessens, you would then start to gradually modify your daily asana practice to slowly and deliberately challenge your endurance, strength and flexibility. If the next day results in more fatigue, you would downgrade your practice to meet the symptoms that are there that day. If all is well, I’d do a few days at a given level of increase in intensity before the next advance of challenge.

Even though the Mayo Clinic only recommends yoga for addressing pain in CFS, as I mentioned above, I think a regular “graded” yoga practice can address many of the symptoms of CFS. And although the research to date is almost non-existent, I hope that the trend towards more research on Yoga and Health will produce more studies to bear out Yoga’s benefit for CFS.

Research Resource: Dr. Timothy McCall lists this study A controlled study of the effect of a mindfulness-based stress reduction technique in women with multiple chemical sensitivity, chronic fatigue syndrome, and fibromyalgia in his 75 Conditions that yoga helps. 

—Baxter

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