Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome.
Goldenberg, D L · Current opinion in rheumatology · 1991 · DOI
Quick Summary
This review examines three related conditions—fibromyalgia, chronic fatigue syndrome, and myofascial pain—that often occur together and cause pain, tiredness, and sleep problems. Researchers are discovering that these conditions may share common biological causes involving how the body senses pain, hormone imbalances, and problems with muscle function. Unfortunately, the new treatments being tested at that time were not particularly effective.
Why It Matters
This work is important because it recognizes ME/CFS as a legitimate medical condition related to fibromyalgia and myofascial pain, validating the symptom clusters patients experience. By proposing shared biological mechanisms—particularly involving pain signaling, hormones, and muscle function—it provides a framework for understanding why ME/CFS patients experience multiple concurrent symptoms and opens avenues for investigating common treatment approaches.
Observed Findings
Recognition of substantial clinical overlap between fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome
Emergence of new diagnostic criteria for fibromyalgia classification from multicenter studies
Early evidence suggesting abnormal nociception (pain sensing) as a common feature
Indications of neurohormonal dysfunction across these related conditions
Evidence of muscle metabolic abnormalities in affected patients
Inferred Conclusions
Fibromyalgia, CFS, and myofascial pain likely share common pathophysiologic mechanisms rather than being entirely distinct disorders
Abnormalities in pain sensation, neurohormone regulation, and muscle metabolism may provide a unifying explanation for the triad of pain, fatigue, and sleep disturbance
Improved classification criteria and understanding of overlap could advance diagnosis and research in these conditions
Remaining Questions
What are the specific molecular and biochemical mechanisms underlying abnormal nociception in these conditions?
Why do current therapeutic approaches show limited effectiveness, and what novel treatment strategies might be more successful?
What This Study Does Not Prove
This editorial does not establish definitive causation for any of these conditions, nor does it prove that FM, CFS, and myofascial pain are the same disorder. The preliminary, uncontrolled pathophysiologic studies reviewed cannot confirm specific biological mechanisms. The review also does not identify effective treatments, making it unclear which interventions would help patients.