Dr Pervushkin · Nizhny Novgorod

Persistent fatigue

Persistent fatigue should not automatically be attributed to stress or tension: anaemia, sleep disorders, endocrine, infectious and other causes should be considered first.

Understanding the concern

What to know before booking

Fatigue warrants assessment when it persists for weeks, limits usual activity or comes with breathlessness, palpitations, weight or temperature change, low mood or disturbed sleep. A chronic fatigue syndrome label should not be used without medical diagnosis.

Initial care usually includes a detailed history, examination and only justified investigations. Medication, nutrition, work schedule, snoring or sleep apnoea, recent infections and emotional load all matter.

After dangerous and treatable causes have been addressed, clinic practitioners may support paced activity, associated muscle tension and recovery skills. This is support, not treatment for an undiagnosed disease.

Reasons to consult

Common concerns

This list helps orientation but does not establish a diagnosis or confirm an indication for osteopathic care.

fatigue not relieved by usual rest
reduced tolerance of normal activity
unrefreshing sleep, disrupted routine or daytime sleepiness
muscle tension and a persistent drained feeling
difficulty concentrating arising alongside general weakness

Initial consultation

How assessment works

Assessment and next steps depend on history, existing investigations and the condition on the day.

01
Duration, previous illness, medication and activity pattern.
02
Basic clinical examination and decision on laboratory or specialist assessment.
03
Review of sleep, recovery, stress and a safe activity level.
04
A paced plan without forced exertion and with a defined review point.

Team approach

Practitioners who may help

Roles are kept distinct: medical diagnosis and treatment are not replaced by wellbeing or consultation practices.

Clinic practitioner

Eduard Pervushkin

As a physician, assesses symptoms, contraindications and the need for primary-care or specialist referral; considers osteopathic care only when indicated.

Qualifications and credentials

Clinic practitioner

Elena Pavlova

Supports gentle body practices, relaxation and recovery routines without claims to boost immunity or cure systemic disease.

Qualifications and credentials

Clinic practitioner

Elena Sharonova

May support stress management and self-regulation after medical causes are assessed; depression or anxiety disorder requires an appropriate clinician.

Qualifications and credentials

Urgent care

Do not wait for a routine visit

Seek urgent medical care or call emergency services for:

!breathlessness or chest pain at rest, or fainting
!sudden weakness, confusion or high fever
!thoughts of self-harm or inability to maintain basic safety

Patient questions

Key questions

Which tests should I do in advance?+

There is no universal panel; tests are selected from history and examination. Broad self-ordered panels often produce incidental findings and do not replace consultation.

Will one osteopathic session help?+

This cannot be promised. Associated functional muscle tension may change, but the cause of persistent fatigue must be assessed independently.

Should I exercise through fatigue?+

Intensity depends on cause and response. Until assessed, avoid a sudden increase in training volume.

Have a question?

We will help you choose the right practitioner

Call the administrator or open Telegram or MAX. Please do not send medical records through public channels.

+7 (910) 395-29-70