Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome.
Goldenberg, D L · Current opinion in rheumatology · 1994 · DOI
Quick Summary
This 1994 review examined three related conditions—fibromyalgia, ME/CFS, and myofascial pain syndrome—that often overlap and remain poorly understood. The author noted that these conditions frequently occur alongside Lyme disease and other medical or psychiatric illnesses. New research at that time suggested that problems with how the central nervous system (the brain and spinal cord) processes signals might play a role in fibromyalgia and ME/CFS.
Why It Matters
This review is historically significant as it documents the early recognition that ME/CFS and fibromyalgia may share common neurobiological mechanisms involving central nervous system dysfunction. Understanding this connection helped establish the foundation for subsequent research into neurovascular, neuroendocrine, and neuroinflammatory abnormalities in ME/CFS. The emphasis on the overlap among these syndromes remains relevant for patients who experience symptoms across multiple categories.
Observed Findings
Three poorly understood syndromes—fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome—show significant clinical overlap.
These conditions frequently co-occur with Lyme disease and other medical and psychiatric illnesses.
New studies at the time suggested potential involvement of central nervous system activation in both fibromyalgia and chronic fatigue syndrome.
No major pathophysiologic breakthroughs or novel therapeutic approaches had emerged in the preceding year.
Inferred Conclusions
Central nervous system dysfunction may be an important contributor to fibromyalgia and ME/CFS pathophysiology.
These three syndromes should be understood as overlapping rather than completely distinct entities.
The frequent association with other medical and psychiatric conditions suggests complex, multifactorial disease mechanisms.
Remaining Questions
What are the specific mechanisms by which the central nervous system becomes dysregulated in these conditions?
Why do these syndromes so frequently co-occur with Lyme disease and psychiatric illness?
What distinguishes the central nervous system abnormalities in fibromyalgia from those in ME/CFS?
What This Study Does Not Prove
This editorial review does not present original experimental data or establish definitive causal mechanisms; it is a synthesis of existing literature and expert opinion. The study does not prove that central nervous system dysfunction is the primary cause of these conditions, only that it may play a role. The historical nature of this 1994 review means it does not capture subsequent advances in ME/CFS research over the past 30 years.