Revue medicale suisseOct 20, 2026

Identifying and treating extreme tiredness after exercise in primary care

Updated Oct 21, 2026

Abstract

Post-exertional malaise (PEM) is a key symptom in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and long COVID.

PEM is characterized by increased fatigue and may include symptoms like muscle pain and cognitive impairment after exertion.
It is now recognized as a significant feature of post-infectious syndromes, particularly long COVID.
Early detection of PEM is associated with better outcomes in managing affected patients.
Appropriate management of PEM is crucial to prevent long-term functional decline.

Simplified

Post-exertional malaise (PEM) is a syndrome characterized by a worsening of symptoms after physical, cognitive, or emotional exertion. It presents as increased fatigue, usually accompanied by other clinical symptoms, such as muscle pain or cognitive impairment. First described in patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), PEM is now recognized as a hallmark of post-infectious syndromes that have received increasing attention through the emergence of long COVID. PEM is a distinguishing symptom of these conditions, and its early detection and appropriate management are essential to prevent long-term functional decline of affected patients. This review describes the definition and clinical impact of PEM and summarizes current recommendations for its management.

Identifying and treating extreme tiredness after exercise in primary care

Abstract

You found one interesting study. We’ll send the next 7.

What Lands in Your Inbox Each Week:

Recent issues from the long covid brief