The involvement of cerebrospinal fluid and lymphatic drainage in chronic fatigue syndrome (CFS/ME)
A novel osteopathic treatment has been discovered during the clinical practice of the author which alleviates many of the symptoms of chronic fatigue syndrome (CFS) known in the UK as CFS/ME. The efficacy of this manual approach was tested using two separate clinical trials. The first examined the change in the symptoms following a year of treatment. The second repeated the first study and examined the possible mechanisms of the improvement. The studies were designed to develop a greater understanding of the disorder, for which there is much scientific uncertainty regarding the cause, diagnosis and treatment. Phase 1 of the research trials included self report questionnaires to examine overall symptom change. With post-exercise fatigue being a major symptom of CFS/ME, the treatment protocol was best evaluated by determining its effects on muscle function which was analysed utilising isometric testing of the knee extensor muscles measuring the impulse torque. The second trial, which included the same self report questionnaires assessing symptom relief as in the initial trial, was divided into two parallel phases. Phase 2 primarily took the form of brain analysis using magnetic resonance imaging (MRI) to confirm if brain abnormalities seen in previous research were found in sufferers of CFS/ME. No cerebral abnormality was detected in the patient group. Central lymph scans were also carried out showing a possible trend of enlargement in CFS/ME sufferers. In the other part, phase 3, isometric tests were repeated with more accurate equipment than in phase 1. Integrated EMG and median frequency of the power spectrum were measured using surface electromyography (sEMG). Overall this study has provided strong evidence that an important component of CFS/ME involves a disturbance of lymphatic drainage of the brain and muscles. The novel osteopathic treatment developed by the author has been statistically validated in both phases of the study, emphasising the need to focus future research on the biomechanical aspectso f this disorder.