| Relative to many of today's diseases and | | | | and mood disorders, and lowered levels of the |
| disorders, little is known about the etiology, the | | | | neurotransmitters norepinephrine and serotonin, |
| cause, and the long-term effects of Chronic | | | | also with an impact on mood and pain, to include |
| Fatigue Syndrome (CFS) and Fibromyalgia | | | | neck pain, back pain, deep hip and pelvis pain, and |
| Syndrome (FMS). The two disorders share a | | | | sciatica. Fibromyalgia sufferers in particular |
| myriad of characteristics, however, which begs | | | | experience a decreased threshold for pain overall, |
| the question: Are they really two separate | | | | at times localized and at other times diffuse and |
| diseases? How does Myofascial Pain Syndrome fit | | | | acute. Chronic fatigue patients will also suffer |
| in? What are the various pain expressions | | | | from idiosyncratic pain, diffuse and varied in its |
| characteristic of each? How are symptoms the | | | | expression. Abnormalities also arise in each of the |
| same or distinct from each other? Neck pain, | | | | nervous system's two branches, the sympathetic |
| back pain, and sciatica have been reported in all | | | | and parasympathetic nervous systems. |
| three conditions but in varying degrees of | | | | FMS and CFS patients may also exhibit disorders |
| intensity and frequency. How are they the same | | | | affecting multiple body systems, the nervous |
| and how are they different? We have already | | | | system, as noted above, the circulatory system, |
| begun to explore the answers to these questions | | | | particularly hypertension and heart-related |
| in previous articles, we will continue to do so in | | | | problems (also a possible stress link) and digestive, |
| this and subsequent articles in this series. | | | | as in ulcers and acid reflux (stress again) and |
| There are many similarities between chronic | | | | endocrine (hormones also impacted by stress). |
| fatigue syndrome and fibromyalgia. The course of | | | | Sleep abnormalities are considerable and |
| both disorders is generally persistent and chronic, | | | | widespread. Interestingly, brain imaging seems to |
| with symptoms arising steadily to a crescendo, | | | | indicate that blood flow wanes to some areas of |
| often waxing and waning in cycles. Unfortunately, | | | | the brain. Symptoms also appear to arise in |
| the prognosis is poor with little real understanding | | | | patients' sensory processing, generating a higher |
| of the etiology or cause. Treatment strategies for | | | | sensitivity to sensory input (light, sound, chemicals) |
| both chronic fatigue and fibromyalgia are focused | | | | and, again, pain stimuli. To summarize, chronic |
| more on symptoms than on treating the | | | | fatigue syndrome and fibromyalgia share a host |
| perceived cause. Pain often varies from dull to | | | | of symptoms, ranging from neurological to |
| acute, from fleeting to constant or chronic. | | | | gastrointestinal. |
| Improvement is possible for those with the | | | | There are symptoms characteristic of each |
| disorder(s), but complete recovery is rare. Most | | | | disease or disorder, chronic fatigue and |
| CFS and FMS sufferers continue to have | | | | fibromyalgia. For example, CFS presents a more |
| symptoms for years, if not decades. | | | | powerful association or link with intolerance to |
| Sufferers of both CFS and FMS also seem to be | | | | exercise, greater fatigue, flu-like symptoms and |
| susceptible to secondary psychological problems, | | | | vision changes. Symptoms found to be more |
| such as depression, anxiety, and mood swings. | | | | prevalent in fibromyalgia include the presence of |
| The psychological and psychosomatic aspects of | | | | the particularly painful trigger and tender points |
| these conditions have not been lost on | | | | and the presence of allodynia. Allodynia is the |
| researchers, with much current research focusing | | | | powerful triggering of pain responses for things |
| on related psychological issues. It is also quite | | | | that wouldn't be painful to an unaffected person. |
| common for depression to become quite serious, | | | | Physicians refer to a certain pain expression from |
| as chronic fatigue symptoms and fibromyalgia pain | | | | movement or motion as "motion allodynia." Pain |
| take a heavy toll. | | | | specialists refer to pain at a comfortable or |
| Treatment for both disorders, FMS and CFS, are | | | | normal temperature, temperature not |
| often similar, if not the same. Increased | | | | uncomfortable to the most people, as "cold |
| occurrence has been demonstrated in blood | | | | allodynia." Allodynia is often used by physicians to |
| relatives, suggesting a possible genetic component | | | | refer to neuropathic or "bizarre" pain, which |
| to the disorder. And, while certain segments of | | | | presents as the result of any non-noxious stimuli, |
| the population seem to be at greater risk, are | | | | often "jumping around from affected to |
| more susceptible, both conditions are present in all | | | | unaffected parts of the body. |
| demographic groups. However, the most | | | | Of the two disorders, CFS is being reported to be |
| susceptible demographic group, for both disorders, | | | | nearing or at epidemic levels, affecting many |
| is women in their middle years, particularly women | | | | persons at the same time across a wide range of |
| from 30 to 50 years of age. Symptoms of both | | | | demographic groups. CFS symptoms wax and |
| fibromyalgia and chronic fatigue syndrome seem | | | | wane more frequently than symptoms of FMS, |
| to worsen after exertion, demanding activity, and | | | | and the rate of disability is greater in chronic |
| stress of all types (physical, cognitive or emotion). | | | | fatigue syndrome patients. Currently, we don't |
| When routine lab tests are conducted on patients | | | | know what the direct (or indirect) connection is |
| with suspected CFS or FMS, the results quite | | | | between chronic fatigue syndrome and |
| often appear normal. Both disorders are | | | | fibromyalgia. Early research and speculation has |
| extremely difficult to diagnose. CFS and FMS | | | | suggested that they could possibly be distinct, |
| often overlap or are found jointly with other | | | | meaning the two disorders are not related, |
| disorders and/or diseases such as allergies, tension | | | | identical, the same disorder, but with different |
| headaches, migraines, irritable bladder, irritable | | | | names, overlapping, two diverse expressions of a |
| bowel and autoimmune disorders. | | | | similar disorder or possibly the result of different |
| Chronic fatigue and fibromyalgia also share | | | | causes or triggers leading to a common pathway, |
| numerous abnormalities not commonly linked to | | | | two subtypes of a larger illness and part of a |
| other disorders. Some of the abnormalities or | | | | spectrum of illnesses, including both...and possibly |
| characteristics peculiar to CFS and FMS include | | | | Myofascial Pain Syndrome. Until further research is |
| central nervous system abnormalities (CNS), | | | | done, it is difficult to say with any degree of |
| perhaps a reason for the various pain expressions | | | | certainty. |