Nijs, Jo, Meeus, Mira, Van Oosterwijck, Jessica et al. · Expert opinion on pharmacotherapy · 2011 · DOI
This review examines how the nervous system can become overly sensitive to pain signals, a condition called central sensitization that occurs in many chronic pain disorders including ME/CFS. The authors summarize different treatment approaches—including medications, physical therapy, brain stimulation, and stress management—that may help calm down an overactive pain processing system in the brain and spinal cord.
Central sensitization is increasingly recognized as a key mechanism in ME/CFS pathology, and this review comprehensively maps available treatment options targeting this mechanism. For ME/CFS patients, understanding multiple potential approaches—from medications to rehabilitation to neuromodulation—may help identify personalized treatment strategies. This work validates central sensitization as a legitimate treatment target in ME/CFS alongside other post-viral and immunological mechanisms.
This narrative review does not provide definitive evidence that any single treatment is effective for ME/CFS specifically—it summarizes theoretical mechanisms and evidence from other central sensitization conditions. The review does not establish which approaches are most effective for ME/CFS patients in particular, nor does it quantify the magnitude of benefit across disorders. It does not address whether treatments targeting central sensitization alone are sufficient or must be combined with other ME/CFS-specific approaches.
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 →
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