What are the Primary Chronic Fatigue Syndrome Symptoms?

There are a number of symptoms commonly thought of as related to chronic fatigue syndrome (CFS). These symptoms may not appear in every patient or all the time in any patient. One of the most frustrating aspects of CFS for patients and physicians is that many chronic fatigue symptoms are also symptoms of other diseases and disorders, some of which may actually accompany the CFS. The following are some of the most common primary symptoms of chronic fatigue syndrome, along with explanations of each.


This type of fatigue is not the kind most people experience due to lack of sleep, hard exercise and other factors. This particular kind of fatigue is best described by patients to be ‘draining’ and the feeling of ‘being done for the day’. This type is not one remedied by a ‘power nap’, caffeine or ‘a second wind’.

Another aspect of this form of fatigue is that a patient may experience it after even only slight exertion, with it lasting longer than 24 hours after that exertion. When a patient experiences this form of fatigue, it can indicate CFS.

For diagnosis, this symptom must have been occurring for at least six months.


This type of pain often feels as if it is in the joints or the muscles close to the joints, to patients. It can come in a variety of forms, such as burning, aching, dull, stabbing and sharp. It tends to move around the patient’s body throughout the day, at times, and can come and go with no discernible pattern.

Though some CFS patients will experience some swelling and inflammation, this particular type of pain is not accompanied by either and must not be accompanied by either for the diagnosis of chronic fatigue syndrome.

Sleep Disorders

It is common for patients with CFS to experience insomnia and non-refreshing sleep, when they do sleep. Non-refreshing sleep occurs when the patient wakes from what could be seven or eight hours of sleep only to feel as if he or she did not get any or much sleep at all. The patient may feel just as exhausted as when he or she went to bed.

Memory Loss and Concentration Issues

It is not unusual for anyone to occasionally forget where they left the car keys or to not be able to concentrate from time to time. The difference for the CFS patient is that these issues can occur rather frequently, to the point of becoming part of daily life.

Low-grade Fever

It is quite common for CFS patients to have a low-grade fever (no higher than 101 degrees Fahrenheit) on any given day or even on most days, with no discernible reason other than having CFS.

Other Symptoms

There are a number of other chronic fatigue syndrome symptoms that may occur. These may be considered secondary or lesser symptoms (in diagnosis). They include headaches, migraines and a weakened immune system.

More of a test factor than a symptom, per se, there are 18 points on the body a physician can apply slight pressure to during diagnosis that may result in pain (when it should not) for the patient. Though these spots may always be tender to the touch, they are not typically thought of as a symptom, but as a means of diagnosis. A chart illustrating these tender points (also common to Fibromyalgia) may be found here.

For a diagnosis of CFS, the patient must experience pain in at least 11 of the 18 tender points.


Chronic Fatigue Syndrome. Mayo Clinic Staff. https://www.mayoclinic.com/health/chronic-fatigue-syndrome/DS00395/DSECTION=symptoms

Chronic Fatigue Syndrome. Medline Plus. U.S. National Library of Medicine, National Institutes of Health. https://www.nlm.nih.gov/medlineplus/ency/article/001244.htm