It is very common that chronic pain patients complain of fatigue.
Many pain patients are not able to carry on with their activities of daily life that many others conduct as a simple routine. These patients are often miss judged as lazy or inactive. They have to listen to lectures from all who may mean well about how they should be more active. It is very frustrating to be misunderstood. If you have chronic pain you would not be able to move well, you can’t have a restful sleep and you are more likely than not, depressed. These are not different unrelated conditions. Each one feeds into another and the total sum will lead into less and less energy.
Many of chronic fatigue conditions can start independent of pain by sources like a viral infection by EBV or a parasitic infestation of Lyme disease, etc. However once the fatigue settles in, most of the times chronic pain follows to appear due to mobility problems and body deconditioning. We lose muscles and develop poor posture when we are fatigued and inactive. Sleep, mood, hormonal and immune system disturbances can follow. One thing leads to another and make the clinical picture more and more complicated.
The other aspect of this story is that many doctors do not know much about chronic fatigue, chronic pain and the inter play among them. We call them co-morbid conditions to give them a fancy name and ease the anxiety of unknown a bit, but most of us feel intimidated by the fact that we can’t solve the problem we are facing.
There are many conditions that we can cure, and some others that we can’t cure but attempt to manage. No matter what the condition may be, dismissing and labeling the conditions as fake and patients as lazy are the worst ways of managing any condition. This does not mean that we should stop motivating patients to be as active as they can. Educating pain and fatigue patients about ways of exercise therapy for better self management outcomes is very helpful to them. Calling them lazy and dismissing their condition as unreal is not helpful at all.