Functional Disorders, Chronic Fatigue, Chronic Pain, 2025, Chattha

[Dolphin]

Functional Disorders, Chronic Fatigue, Chronic Pain

It is sometimes helpful to characterize medical conditions as either structural (with abnormalities is specific anatomic structures that can be identified through organ-specific testing) and functional (when body parts are not communicating and coordinating physical...

link.springer.com

Functional Disorders, Chronic Fatigue, Chronic Pain​

• Chapter
• First Online: 02 January 2026
• pp 77–95

• Asma J. Chattha,
• Samuel G. Porter &
• Philip R. Fischer

• 11 Accesses

Abstract​

It is sometimes helpful to characterize medical conditions as either structural (with abnormalities is specific anatomic structures that can be identified through organ-specific testing) and functional (when body parts are not communicating and coordinating physical processes appropriately even though all test results are normal).

Some patients have both structural and functional disorders, concurrently; it is important to treat each cause of an adolescent’s symptoms.

Chronic fatigue and chronic pain are common and often not linked to specific test abnormalities.

Patients with dysfunction of the autonomic nervous system can have orthostatic intolerance and chronic fatigue; some have excessive postural tachycardia and qualify for a diagnosis of postural orthostatic tachycardia syndrome.

All of these patients can respond favorably to specific changes in intake, activity, sleep, and mindset (with cognitive behavioral therapy).

Sometimes, specific medications provide adjunctive benefits for pain and for postural orthostatic tachycardia syndrome.

Clinicians can guide patients with functional disorders to good recovery.

 

[Dolphin]

Includes the following (I don't have the full quote):

Some patients get consumed by internet information about “chronic fatigue
syndrome” and end up either believing in unproven treatments or anticipating a life-long condition. While “chronic fatigue syndrome” is a legitimate diagnosis for research

 

[SNT Gatchaman]

That's in the section on Chronic Fatigue, part of "Adolescent Medicine in the Middle East: Principles, Perspectives, Practices"

Words Matter
Some patients get consumed by internet information about “chronic fatigue syndrome” and end up either believing in unproven treatments or anticipating a life-long condition. While “chronic fatigue syndrome” is a legitimate diagnosis for research studies, it is often more clinically useful to refer simply to “chronic fatigue” as validation that the tiredness has happened for a long time but with the anticipation that recovery is likely.

Also —

Treatment of Chronic Fatigue Should Be Multifaceted
… the treatment of functional chronic fatigue also requires a team. The family and patient should join with the care team in ensuring good sleep quality and quantity, every night. The patient and family should commit to daily aerobic exercise, typically for at least half an hour; strength training can also be helpful. The care team needs to consistently stress the value of exercise since the fatigued patient usually lacks any motivation to exercise when feeling so tired. Having a personal trainer or coach or physical therapist can be helpful. The family and patient should work together to standardize schedules of healthy meals. Cognitive behavioral therapy is of proven effectiveness in overcoming chronic fatigue, so psychology input is useful. Fatigued patients do best when they engage in regular school activities. Staying home and limiting activities serves only to worsen the fatigue. However, the school team should be supportive rather than punitive during the rare times that the patient is unable to either attend school or complete assignments in a timely fashion.

What about the other 30% of medical visits? How do we view the third of patients who present with bothersome symptoms not accompanied by any abnormal finding? It is helpful to consider illnesses as either structural or functional. Structural disorders can be identified by physical exam and/or test abnormalities. Functional disorders result from brain-nerve dysfunction, causing symptoms without any specific pathology identified on evaluation of specific body parts. Approximately 30% of medical visits are related to functional disorders. Examples of functional disorders include chronic migraine headaches, irritable bowel syndrome, and postural orthostatic tachycardia syndrome.

Some physicians have the idea that structural disorders are real and function disorders are imaginary. Certainly, a patient with severe monthly headaches that are preceded by an aura, that are associated with vomiting, and that are relieved gradually by sleep, should not be told that a negative MRI study means the patient is normal. Rather, we would be able to diagnose a specific functional disorder, that of migraine headaches.

Chronic fatigue, with or without the orthostatic intolerance and excessive postural tachycardia of postural orthostatic tachycardia syndrome, can be a functional disorder. […] In some situations, the dysfunctional body-brain connection seems to be more fully disrupted. Non-epileptic seizures and seeming blindness and paralysis (conversion) result when the brain’s intended messages completely fail to be implemented by the body. Functional disorders can affect sensory, motor, and autonomic nervous systems. Functional disorders are distinct from but can interact with psychiatric disorders; functional disorders are not merely psychogenic.

 

[rvallee]

functional (when body parts are not communicating and coordinating physical processes appropriately even though all test results are normal)

Oh, that's not what it means, that's not what it means at all. Come on. Nothing good in history has ever come out of this much dishonesty. Absolutely nothing.

Also, wow is this clueless about ME/CFS.

Functional disorders result from brain-nerve dysfunction, causing symptoms without any specific pathology identified on evaluation of specific body parts.

There is zero evidence of this. When bullshit finds its way into textbooks, so many things have gone wrong that the whole system that allowed it becomes suspicious.

Non-epileptic seizures and seeming blindness and paralysis (conversion) result when the brain’s intended messages completely fail to be implemented by the body.

This doesn't even mean anything. "Fail to be implemented by the body", what the hell? Complete Goop stuff.

This is human slop. Even AI is already better at this. Good grief, this expertise is rotting from the inside out.