Understanding Fatigue

Chronic fatigue is a very debilitating symptom in itself and doubly so when associated with chronic pain or other health conditions.

It is incredibly hard to make someone who hasn’t experienced it understand and because there are no outward signs of fatigue people often don’t believe you.

We get it. We understand that every day it feels like you are wading neck deep in treacle just trying to achieve the simplest of tasks. Actress Miranda Hart described it feeling like climbing Mount Everest every time you climb the stairs to the loo. There is a wonderful article for explaining fatigue to those around you – The Spoon Theory.

Fatigue is a very frustrating symptom but there are a combination of things that you can do to help ease it. It won’t be an overnight fix as it takes 90 days for stress hormone adjustments to be maintained by the hypothalamic pituitary adrenal axis. These are the parts of the brain and the glands responsible for controlling and producing our stress hormones. When we have been under stress for a long time and stuck in survival mode this system gets exhausted and either stops producing the correct amount of cortisol or stops responding to the amount produced. It is important that bodies have cortisol levels higher in the morning as this is what helps wake us up and gets us going. Often with chronic or adrenal fatigue this is not happening meaning mornings are hard. There is nothing like feeling tired before you have got out of bed. The other factor regarding cortisol is that it can sometimes be too high at night instead. This can contribute to insomnia; the cruel cousin of fatigue. See our Sleep page for help with insomnia.

With what we know about the relationship between chronic pain and illness and its relationship to stress, none of this is surprising and we can use many of the same techniques to help reduce the fatigue that we do to help reduce the pain.

So what tools help?  We would look at what you as an individual require and your needs will depend on where you are in your recovery journey but whatever you find that starts to balance out your stress response is a good place to start.

Identifying Your Stressors

Addressing what is causing your current, ongoing and previous or chronic stress is important. You may have tried many things to help your fatigue but have you ever asked yourself – what am I missing? What do I need? What am I frightened of? What will I have to do if I get more energy? What made me tired? What can I do to feel nourished (emotionally)? Why don’t I feel safe? What was happening when it started? It is worth journaling the answers to any of these questions if they feel relevant and any others that come into your head. Often this helps to identify the key stressors that are implicated in your fatigue or pain. If anything comes up from these answers we recommend speaking to one of our SIRPA trained osteopaths who can help guide you with reframing these thoughts.


This is important when you have fatigue. Many people who suffer with fatigue are achievers who just keep pushing on. But once fatigue kicks in we advise pacing yourself to initially about 25% to 50% of what you think, or want, to achieve. This is hard but in order to recover you will need to initially cut right back as much as possible to be able to build your reserves. We recommend therapeutic rest whenever you feel tired or overwhelmed. Therapeutic rest is also excellent for the digestive tract and if done after meals can help give your body time to absorb all the nutrients in your food.


Keeping your body sustained with the food it needs is essential and challenging because the sheer energy of trying to prepare healthy and nutritious meals can be tiring. On our Diet & Chronic Pain page we lay out some simple tips for making this easier and recommend some food choices that will help to sustain and stabilise your energy. If you like a plan ‘The Adrenal Recovery Collective’ who have produced a 7 day menu sheet to aid with fatigue which we have included in the resources of this page.


As well as helping you rest and relax meditation can help you reboot your nervous system and teach your body to come out of the stress response associated with fatigue.

There are some really effective short, 15 minute, meditations on our Meditation page that you can do while resting. There are also some fatigue specific meditations in the resources section at the bottom of this page. Alongside these meditations are 2 links to Emotional Freedom Technique (Tapping) routines for fatigue.

Osteopathy for Chronic Fatigue

Our osteopaths can use gentle osteopathic techniques to help your body relax and settle which helps to balance the stress response. In conjunction with the other tools this can help to reduce the fatigue. From a classical osteopathic philosophy point of view, reducing tension and balancing your body can also mean it requires less energy to maintain upright.

UK Osteopath, Dr Raymond Perrin, has published a system of osteopathic treatment and lymphatic drainage to decrease the symptoms of chronic fatigue. None of our osteopaths are trained specifically as Perrin practitioners but we are aware of the research and can apply cranial osteopathic techniques and lymphatic drainage to help stimulate your body’s drainage system. If you want to learn more about the role lymphatics play in our body and want to work on your own lymphatic system there is more information on the Lymphatics page.


Spoon Theory

Fatigue - Overcoming Everyday Blues and Fatigue

Guided self help hypnosis/meditation 30 minutes.

Exercising the Thyroid

EFT Tapping Links

If you are new to Emotional Freedom Technique (tapping) then please check out our EFT page – some people find it really helpful, some don’t. Studies show that tapping can influence your cortisol levels so it may be worth adding to your tool box.

EFT Tapping to Increase Energy

Tap from Exhausted to Energised

Other 'Fatigue & Sleep' Toolkits

You may be interested in our other ‘Fatigue & Sleep’ chapters within the Mindbody Toolkit: