Yunus, Muhammad B · Seminars in arthritis and rheumatism · 2007 · DOI
This paper proposes that fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome, and certain headaches may all share a common underlying problem: the nervous system becomes too sensitive to pain and other signals. Rather than being separate diseases, they might be related conditions caused by similar changes in how the brain and body communicate, combined with stress and emotional factors.
This conceptual framework is important for ME/CFS patients and researchers because it challenges the idea that these are separate, purely psychiatric conditions and instead proposes a biological mechanism involving nervous system dysfunction. If validated, it could shift clinical approaches toward treating underlying pathophysiology and improve how physicians understand the interconnected nature of patients' symptoms.
This review does not prove that central sensitization causes ME/CFS or that all CSS conditions share an identical mechanism—the authors themselves note evidence is weak or absent in some members. It does not establish causation or explain the full biology; it proposes a framework for future investigation rather than settling the question of what causes these diseases.
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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