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Treatment and management

Treatment and management

Please be aware that given recent publications and emerging evidence, this page is currently under review.

While there is currently no pharmaceutical cure for M.E. there are a number of conventional medical approaches and complementary therapies which may help to alleviate symptoms.

Because of the complexity of the illness, its fluctuating nature and the wide spectrum of symptoms, different things work for different people. Some, particularly those who are more severely affected, unfortunately find currently available therapies of little benefit.

The NICE guideline for M.E. and  Scottish Good Practice Statement on M.E./CFS offer guidance on:

  • symptom management, including pharmacological interventions
  • function and quality-of-life management, including sleep, rest, pacing and diet
  • referral to specialist care, including management and activity programmes.

Both stress that the following should not be offered to people with M.E.:

  • advice to undertake unsupervised or unstructured vigorous exercise (such as “going to the gym” or “exercising more”) because this may worsen symptoms
  • specialist management programmes delivered by practitioners with no experience in the condition
  • an imposed rigid schedule of activity and rest.

The British Association for CFS/M.E. (BACME) also publishes a therapy and symptom management guide. This practical clinical treatment summary incorporates existing tools and methodologies from specialists who work with adults and children who have M.E., and offers a consensus approach to broader treatment based on clinician expertise, patient experience and the best available evidence. It's free to download at BACME's website.

Pacing and energy-management

Surveys by Action for M.E. and other M.E. charities have consistently shown that the majority of people with M.E. find that pacing (ie. managing physical, mental and emotional activity and rest) helps them to manage their illness.

When pacing, patients organise their day into sustainable activity and regular rest, helping them to avoid setbacks. It gives stability and a sense of control, making things more predictable and enhancing confidence.

The key to pacing lies in understanding what is meant by available energy, types of activity, rest, finding a baseline, and planning and setting realistic goals.

Useful resources include Action for M.E.’s Pacing for people with M.E. booklet, widely used by M.E. patients and healthcare professionals, and the BACME guide highlighted above.

Map of medicine

M.E. is one of the topics included in the Map of Medicine, a web-based tool that provides 350 evidence-based, best-practice clinical pathways as an interactive flowchart of detailed processes. These pathways can be localised to help plan, communicate and implement local services and priorities.