Research theme 4: Improving management

Fatigue and pain commonly co-exist in people with chronic fatigue states and while each can separately impact on function and quality of life, the presence of fatigue and pain together likely has the most adverse effect. In addition to worsened symptoms, the co-occurrence of fatigue and pain might also negatively impact one’s ability to participate in graded exercise therapy (GET), an important part of treatment known to improve fatigue and physical function¹. In fact, data from our clinic show that people with more pain at baseline are less likely to respond to multidisciplinary treatment².

We are currently investigating the association between fatigue and pain during the development, and after the establishment, of a chronic fatigue state. We are also investigating whether hallmark features of chronic fatigue states, such as mood and sleep disturbances, influence the fatigue-pain association. In these studies, we will use validated questionnaires to assess sleep, mood, fatigue and pain. Pain will also be assessed using ‘quantitative sensory testing‘ – a neurophysiological technique that allows investigation of the sensitivity of the nervous system (i.e. central sensitisation, common in people with chronic fatigue states)³.

¹  _{Larun, L., Brurberg, K.G., Odgaard-Jensen, J. and Price, J.R. (2019). Exercise therapy for chronic fatigue syndrome. Cochrane Database Syst Rev, 10:CD003200}

²  _{Sandler, C.X., Hamilton, B.A., Horsfield, S.L., Bennett, B.K., Vollmer‐Conna, U., Tzarimas, C. and Lloyd, A.R. (2016). Outcomes and predictors of response from an optimised, multidisciplinary intervention for chronic fatigue states. Intern Med J, 46: 1421-1429.}

³  _{Sandler C.X. and Lloyd A.R (2020). Chronic fatigue syndrome: progress and possibilities? Med J Aust, 212(9): doi: 10.5694/mja2.50553.}