Mezhov, Veronica, Guymer, Emma, Littlejohn, Geoffrey · Internal medicine journal · 2021 · DOI
Fibromyalgia and ME/CFS are conditions where the nervous system becomes oversensitive, causing widespread pain, fatigue, sleep problems, and brain fog. These conditions often occur together and share similar underlying problems with how the brain and spinal cord process pain and other signals. This review explains what causes these conditions and how doctors can recognize and treat them using a combination of education, exercise, stress management, and medications.
This review is important for ME/CFS patients and researchers because it positions ME/CFS within the broader framework of central sensitivity syndromes, helping explain why ME/CFS patients often experience multiple overlapping conditions and why their symptoms may not fit traditional disease categories. Understanding central sensitisation as a unifying mechanism provides a scientific rationale for integrated, multidisciplinary treatment approaches that address nervous system dysfunction rather than seeking a single infectious or inflammatory cause.
This review does not prove that central sensitisation is the sole cause of ME/CFS or fibromyalgia, nor does it establish the directionality of causation—whether nervous system changes cause the clinical syndrome or result from it. The review synthesizes existing literature and does not present new experimental data or long-term outcome studies demonstrating the efficacy of the proposed integrated treatment approach specifically in ME/CFS populations.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
Spotted an error in this entry? Report it →