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Abstract
A patient (46 years; female) with a 6 year history of chronic fatigue syndrome was treated with a thoracic rotational movement, which effected an instant and major improvement in symptoms. It is argued that dysautonomia, enhanced by joint hypermobility syndrome, was the major factor behind this patient's condition. It is believed that due to a previous injury and joint hypermobility syndrome, the sympathetic nervous system tissues were traumatised, resulting in dysautonomia. In this paper it is proposed that dysautonomia is a primary presentation of chronic fatigue syndrome (CFS), fibromyalgia syndrome (FMS) and joint hypermobility syndrome (JHS). Because of their similarities it is suggested that there may be a subgroup of CFS and FMS patients who are also hypermobile. It is believed that by finding a directional preference, physiotherapy may be able to influence the autonomic nervous system symptoms associated with these conditions. This would suggest a potential role for physiotherapy in the treatment of these prevalent and intractable conditions, and highlights the importance of further research in this area.