Patients with chronic Fatigue / Brain Fog

I’ve been seeing more and more patients complaining of chronic, diffuse joints pain (often stating that they have hEDS as told by TikTok) along with fatigue, brain fog, and really limited tolerance for even mild activity. A lot of them feel like physical therapy makes things worse and are hesitant to try medication or find them unhelpful. In the last two weeks I have had two patients request that I fill out disability paperwork. I find these visits challenging, especially when the exam is largely unremarkable and the usual approaches don’t seem to help or are declined. I want to support them and validate what they’re experiencing, but I also feel stuck in terms of what to offer.

Admittedly I’ve noticed some frustration and bias creeping in on my end. For those of you who see similar patients, how are you approaching this in a way that still feels helpful and grounded?

Author: nrbanana