Post-Exertional Malaise in Fatiguing Diseases: What to Know

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Post-exertional malaise (PEM) is a significant phenomenon in conditions such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID, characterized by worsening symptoms after exertion. A study at the American College of Rheumatology (ACR) meeting found PEM in many rheumatologic conditions, associated with worse symptoms. Experts stress the importance of assessing PEM, cautioning against graded exercise for those experiencing it. They recommend pacing activities to avoid PEM, as well as providing information on the condition. Improved assessment tools are being developed to better identify and manage PEM in patients, with a focus on avoiding harm and promoting recovery.

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