Rest has no place in treating chronic fatigue

“Go home and rest” is still the advice given to many patients who complain of chronic fatigue. The refrain is echoed in self help books and magazines and adopted by many patients. What are the origins of rest as a treatment, does it work, and what evidence is there on which to base our advice to patients?

Chronic fatigue syndromes are not new.1 Victorian physicians diagnosed them as neurasthenia and routinely prescribed rest. This approach was typified by Silas Weir Mitchell's “rest cure,”2 which was so popular as to be described as “the greatest advance of which practical medicine can boast in the last quarter of the century.”3 Despite such accolades, the popularity of the rest cure was short lived. By the turn of the century the same private clinics that once provided it were changing to more active treatments and to the newer psychotherapies.1 The …