Medical History and Physical Exam for Chronic Fatigue Syndrome

Fatigue has many possible causes. The history and physical exam are the first steps in determining other possible causes of fatigue and what tests may be needed to check for other conditions.

Medical history

The medical history for chronic fatigue syndrome (CFS) includes questions about your fatigue and other symptoms. The questions will cover:

• When your fatigue began, how severe it is, and whether it comes and goes in a specific pattern.
• Specific symptoms, such as swollen, red joints, muscle pain, headache, forgetfulness, memory loss, irritability, or difficulty concentrating.
• Your health habits, including sleep, diet, and exercise, and whether there have been any recent changes in these habits.
• Recent stressful events, such as a change in employment, loss of a loved one, or difficult family relationships.
• What medicines you are taking.
• Your past medical history.
• Alcohol and drug use.
• Family history of fatigue problems.
• What you think might be causing your fatigue.

Try to describe your symptoms in detail. Writing out a complete history of your illness before you see the doctor may be helpful.

The doctor also may ask about your mental health. Depression can contribute to fatigue and other symptoms. Treating depression often can improve CFS symptoms as well.

Physical exam

The doctor will do a complete physical exam to evaluate your symptoms and screen for other conditions that could be causing your fatigue.

The physical exam will help your doctor decide whether you need further testing and what kind of testing you need. For example, if the doctor finds that you have swollen, red joints, you may need tests to rule out conditions that can cause joint pain, such as rheumatoid arthritis or lupus.