Post-exertional malaise

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Post-exertional malaise
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Worsening of symptoms after physical or mental exertion
Complications	N/A
Onset	Typically within 12 to 48 hours after exertion
Duration	Days to weeks
Types	N/A
Causes	Physical exertion, mental exertion
Risks	Chronic fatigue syndrome, myalgic encephalomyelitis
Diagnosis	Clinical evaluation
Differential diagnosis	Fibromyalgia, depression, anxiety disorders
Prevention	N/A
Treatment	Pacing (activity management), cognitive behavioral therapy, graded exercise therapy
Medication	N/A
Prognosis	N/A
Frequency	Common in individuals with chronic fatigue syndrome
Deaths	N/A

Timeframe of PEM from daily activities

Post-exertional malaise after 2-day CPET

Post-exertional malaise (often abbreviated as PEM) is a hallmark symptom of Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME). It is characterized by a severe worsening of symptoms following physical or mental exertion, with symptoms typically worsening 12 to 48 hours after activity and lasting for days or even weeks.

Definition

Post-exertional malaise is defined as an extreme, prolonged reaction to physical or mental exertion, characterized by worsening of symptoms and a loss of physical and mental stamina. This is not to be confused with the normal fatigue that healthy people may feel after exercise. PEM is a key diagnostic criterion for ME/CFS.

Symptoms

Symptoms of post-exertional malaise can include extreme fatigue, pain, cognitive difficulties, unrefreshing sleep, flu-like symptoms, and a worsening of the individual's usual symptoms. These symptoms can last for days or weeks and can be debilitating.

Causes

The exact cause of post-exertional malaise is not known, but it is thought to be related to the body's inability to recover after exertion. This may be due to abnormalities in the immune system, the nervous system, or the body's energy production systems.

Treatment

There is currently no cure for post-exertional malaise. Treatment is focused on managing symptoms and avoiding triggers, such as overexertion. This often involves a program of carefully paced increase in activity, known as pacing.

See also

• Chronic Fatigue Syndrome
• Myalgic Encephalomyelitis
• Pacing (activity management)

References

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