| Post-exertional malaise | |
|---|---|
| Other names | Post-exertional symptom exacerbation (PESE) Postexertional malaise (PEM) Post-exertional neuroimmune exhaustion (PENE) |
 | |
| Chart of physical, cognitive, and emotional activities that may trigger PEM | |
| Symptoms | Worsening of symptoms after ordinary activity |
| Causes | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Long COVID[citation needed] |
| Treatment | Symptomatic |
Post-exertional malaise (PEM), sometimes referred to as post-exertional symptom exacerbation (PESE)[1] or post-exertional neuroimmune exhaustion (PENE),[2] is a worsening of symptoms that occurs after minimal exertion. It is the hallmark symptom of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and common in long COVID and fibromyalgia.[3][1] PEM is often severe enough to be disabling, and is triggered by ordinary activities that healthy people tolerate. Typically, it begins 12–48 hours after the activity that triggers it, and lasts for days, but this is highly variable and may persist much longer.[4][5][6] Management of PEM is symptom-based, and patients are recommended to pace their activities to avoid triggering PEM.
- ^ a b Clinical management of COVID-19 Living Guideline. World Health Organization. January 13, 2023. pp. 113–4. Archived from the original on May 22, 2023. Retrieved January 14, 2023.
- ^ Twisk F (December 20, 2018). "Myalgic Encephalomyelitis or What? The International Consensus Criteria". Diagnostics. 9 (1): 1. doi:10.3390/diagnostics9010001. ISSN 2075-4418. PMC 6468846. PMID 30577429.
- ^ Barhorst EE, Boruch AE, Cook DB, Lindheimer JB (2022). "Pain-Related Post-Exertional Malaise in Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia: A Systematic Review and Three-Level Meta-Analysis". Pain Medicine. 23 (6): 1144–1157. doi:10.1093/pm/pnab308. PMID 34668532. Archived from the original on May 21, 2023. Retrieved February 11, 2024.
- ^ "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Symptoms". Centers for Disease Control and Prevention. U.S. Department of Health & Human Services. July 14, 2017. Archived from the original on August 22, 2020. Retrieved September 23, 2017.
- ^ "Terms: Post-exertional malaise". Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management - Recommendations. NICE (Report). October 29, 2021. NICE guideline NG206. Archived from the original on December 29, 2021. Retrieved May 12, 2022.
- ^ "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness" (PDF). National Academy of Medicine. 2015. pp. 78–86. Archived (PDF) from the original on January 20, 2017. Retrieved May 12, 2022.