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Chronic fatigue syndrome (CFS) is a condition marked by extreme fatigue that does not get better, even with rest, and gets worse with physical and mental exertion. Its pathophysiology remains unknown despite of intensive research on several pathological factors. The therapeutic treatment for CFS is very limited in conventional medicine settings.
As an alternative medicine, traditional Chinese medicine (TCM) has provided some evidences based upon ancient texts and recent studies. Recently, acupuncture treatment for CFS has gradually attracted physicians’ and patients’ attention. A 2019 literature review suggests acupuncture may have promise as a treatment, though experts agree on the need for more research. [1]
What is fatigue?
Fatigue is more than being tired or sleepy. People who have fatigue feel so drained that their exhaustion interrupts their daily life. Many conditions and medications can cause overwhelming tiredness. An unhealthy diet, lack of sleep and too little or too much physical activity can also lead to fatigue.
If you live with fatigue, you might feel too tired for many daily activities, including:
Personal hygiene and grooming
Spending time with children
Workplace responsibilities
Household chores
Socializing and hobbies
Exercise
Arranging meals
Fatigue can happen as a symptom of many health conditions, including:
Chronic fatigue syndrome (CFS) requires your attention
If your tiredness can’t be explained by another medical condition, you could have chronic fatigue syndrome (CFS). This condition involves persistent fatigue that interferes with work, school, and other aspects of daily life for at least 6 months.
If you have CFS, you may:
Feel exhausted for at least a day after physical activity or a mentally challenging task
Still feel tired after a full night of sleep
Notice lingering aches and pains in your muscles and joints
Get headaches and sore throats frequently
Notice tenderness in your lymph nodes
Experience brain fog, or trouble concentrating, retaining information, and remembering things
Feel depressed and lack of desire to do the activities you once enjoyed
have nervousness, anxiety, impatience, and irritability
Have stiff shoulders
Feel sleepiness
Acupuncture for chronic fatigue syndrome
In Traditional Chinese Medicine, CFS falls in the scope of Energy Deficiency (Xu Lao 虛勞), Atrophy Syndrome (Wei Zheng 痿症), Depressive Disorder (Yu Bing 鬱病), and Lily Disease (Bai He Bing 百合病). Based on Chinese medicine theory, acupuncture can promote the circulation of “meridian Qi”, regulate “Qi” and “Blood”, balance “Yin” and “Yang”, and thus restore the function of “Zang-Fu” organs via acupuncture signals generated from acupoints.
Acupoints commonly used in fatigue treatment include [2] [3]:
CV6 (Qihai 氣海)
CV4 (Guanyuan關元)
ST36 (Zusanli足三里)
LI4, LV3 (Siguan: Hegu plus Taichung 四關穴:合谷配太沖)
BL23 (Shenshu 腎俞)
GB20 (Fengchi 風池)
Acupoints were selected to achieve the therapeutic actions guided by the treatment principles. Baihui is located on the Governing Vessel (Du Mai督脈). Administering acupuncture at this acupoint lifts Yang, boosts Qi, and revives the spirit mind (shen). Qihai, and Guanyuan are located on the Conception Vessel (Ren Mai任脈). Acupuncture at these two acupoints supports upright Qi (Zheng Qi 宗氣) and benefits the kidneys. Zusanli combined with Sanyinjiao is often used in modern clinical settings to strengthen the spleen and stomach and to benefit Qi and blood. Siguan was applied to restore the liver’s function to control the smooth flow of Qi and activate Qi and blood circulation. [2]
Acupuncture And TCM Treatment For Fatigue And Its Effects
A TCM doctor will choose acupuncture points and a combination of herbs that will help harmonize the affected Zang-Fu systems. With herbs, we are able to get energies into the body beyond what you can do with foods alone. A balanced diet and suitable exercise are also important for recovering strength and energy.
The effects of acupuncture for fatigue is well studied:
Four weeks of acupuncture treatment led to improvements in CFS symptoms. [4]
Reduction in the severity of fatigue. [5]
Adjusting immune dysfunction, regulating abnormal activity in the hypothalamic-pituitary-adrenal (HPA) axis and serving as an antioxidant. [6]
Moxa treatment in particular became more and more effective as treatment sessions continued past the 10th treatment. Moxibustion was shown to have an effect on the vagus nerve, which controls the parasympathetic nervous system. [7]
Acupuncture and TCM has advantages such as being natural, effective and safe to ameliorate symptoms of CFS such as fatigue, disordered sleep, cognitive handicaps and other complex complaints. How long it takes to get results from acupuncture treatment for chronic fatigue will vary from person to person, depending on how long the person has been experiencing CFS, and how deeply the organ systems are affected. TCM treatment has a cumulative effect which strengthens over time and several sessions. If you or someone you love has been feeling exhausted for months without improvement, it may be time to consider trying acupuncture for chronic fatigue.
Zhang Q, Gong J, Dong H, Xu S, Wang W, Huang G. Acupuncture for chronic fatigue syndrome: a systematic review and meta-analysis. Acupunct Med. 2019 Aug;37(4):211-222. doi: 10.1136/acupmed-2017-011582. Epub 2019 Jun 17. PMID: 31204859.
Lu C, Yang XJ, Hu J. [Randomized controlled clinical trials of acupuncture and moxibustion treatment of chronic fatigue syndrome patients]. Zhen Ci Yan Jiu. 2014 Aug;39(4):313-7. Chinese. PMID: 25219128.
Lin, W., Chen, Xl., Chen, Q. et al. Jin’s three-needle acupuncture technique for chronic fatigue syndrome: a study protocol for a multicentre, randomized, controlled trial. Trials 20, 155 (2019). https://doi.org/10.1186/s13063-019-3243-5
Kim JE, Seo BK, Choi JB, Kim HJ, Kim TH, Lee MH, Kang KW, Kim JH, Shin KM, Lee S, Jung SY, Kim AR, Shin MS, Jung HJ, Park HJ, Kim SP, Baek YH, Hong KE, Choi SM. Acupuncture for chronic fatigue syndrome and idiopathic chronic fatigue: a multicenter, nonblinded, randomized controlled trial. Trials. 2015 Jul 26;16:314. doi: 10.1186/s13063-015-0857-0. PMID: 26211002; PMCID: PMC4515016.
Zhang Q, Gong J, Dong H, Xu S, Wang W, Huang G. Acupuncture for chronic fatigue syndrome: a systematic review and meta-analysis. Acupunct Med. 2019 Aug;37(4):211-222. doi: 10.1136/acupmed-2017-011582. Epub 2019 Jun 17. PMID: 31204859.
Chen R, Moriya J, Yamakawa J, Takahashi T, Kanda T. Traditional chinese medicine for chronic fatigue syndrome. Evid Based Complement Alternat Med. 2010 Mar;7(1):3-10. doi: 10.1093/ecam/nen017. Epub 2008 Feb 27. PMID: 18955323; PMCID: PMC2816380.
Shu, Q., Wang, H., Litscher, D. et al. Acupuncture and Moxibustion have Different Effects on Fatigue by Regulating the Autonomic Nervous System: A Pilot Controlled Clinical Trial. Sci Rep 6, 37846 (2016). https://doi.org/10.1038/srep37846