Fibromyalgia & ME/CFS: A Quick Overview

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By Bruce Campbell

Fibromyalgia and ME/CFS (Myalgic Encephalomyelitis / Chronic Fatigue Syndrome) are common, long-term medical conditions. Both are now widely recognized as real illnesses, not psychological problems. Diagnostic criteria have been established for both and a diagnosis of either condition qualifies a person to receive disability payments.

ME/CFS is also known by other names, such as ME, CFS, and, in the past, Chronic Fatigue and Immune Dysfunction Syndrome [CFIDS].)

The severity of both conditions varies widely. Some people have mild cases and continue to lead relatively normal lives, while most are affected more deeply. The average case of fibromyalgia or ME/CFS creates moderate to severe symptoms and reduces a person's activity level by 50% to 85%.

As long-term conditions, fibromyalgia and ME/CFS affect many parts of people' lives, including relationships, career, moods, and finances. FM and ME/CFS both create challenges and require adaptations. Adaptations may include reducing or eliminating paid work, adjusting family responsibilities, managing increased stress and intense emotions, and coming to terms with loss.

Research suggests that there are probably more than one million people with ME/CFS in the United States, about three-quarters of whom are women. Estimates of the prevalence of fibromyalgia vary, but there are probably at least four to five million people in the United States with FM, possibly many more. Studies suggest that more than 90% are women.
 

Symptoms

Both fibromyalgia and ME/CFS are characterized by the presence of multiple symptoms, which are usually moderate to severe in intensity. Many people with FM and/or ME/CFS also have additional medical problems as well.

The most prominent symptom of fibromyalgia is widespread pain, which is generally felt all over the body, although it can start in one region and spread or move from one area to another.

The pain may be accompanied by neurological problems such as tingling and burning or numbness in the hands, arms, feet, legs or face. Pain may be intensified by overactivity, non-restorative sleep, anxiety and stress, and changes in the weather.

Other common symptoms of fibromyalgia include unrefreshing sleep, fatigue and cognitive difficulties that are often called "fibro fog." These include confusion, difficulty concentrating, fumbling for words and lapses in short-term memory.

Most patients suffer from a sleep disorder, but poor sleep can also be increased by stress, overactivity, and the absence of a good sleep environment or good sleep habits.

People with fibromyalgia may also experience many other symptoms, including tension or migraine headaches, strong emotions such as depression and anxiety, jaw pain, ringing in the ears, dizziness, rashes, sensitivity to light, sounds, smells and temperature, and dry eyes or dry mouth.

The central symptom of ME/CFS is a fatigue that is experienced as deep exhaustion. Fatigue can be intensified by overactivity, poor sleep, deconditioning, stress, emotions and poor nutrition. Other prominent symptoms include pain, sleep that is not refreshing and cognitive problems similar to those in fibromyalgia.

Additional symptoms that often appear with ME/CFS include headaches, low-grade fevers, sore throat, tender lymph nodes, anxiety and depression, ringing in the ears, dizziness, abdominal pain (gas, bloating, periods of diarrhea and/or constipation), allergies and rashes, sensitivity to light and sound, abnormal temperature sensations such as chills or night sweats, weight changes and intolerance of alcohol.

A majority of people diagnosed with either ME/CFS or fibromyalgia are later found to have the other condition as well.

In addition, people with either or both conditions often have additional medical problems, such as irritable bowel syndrome (IBS), food and chemical sensitivities (such as candida, celiac disease and lactose intolerance), myofascial pain, orthostatic intolerance, Lyme disease, myofascial pain syndrome, sleep disorders like apnea and restless legs syndrome, and thyroid conditions.
 

Treatments

Because no cure has been developed so far for either condition, treatment aims at managing symptoms and improving quality of life. Approaches include medications, alternative treatments and self-help measures.

Medical treatment is tailored to the individual patient, often focusing on addressing the most bothersome symptoms such as poor sleep and pain. Since no medication is consistently effective, there is often a period of experimentation to find what works for a given individual. Medications may have to be changed periodically, as they can lose effectiveness. Patients are usually started with very low dosages.
 

Lifestyle adaptations are more consistently helpful. The most common technique for limiting fatigue is to adjust to the limits imposed by illness, using strategies such as reducing overall activity, taking regular rests and having short activity periods.

Pacing is usually helpful with pain as well. Staying within activity limits, having short activity periods, switching from task to task frequently and taking rest breaks all reduce pain.

Adapting to either condition requires individual adjustments. There are many different patterns of symptoms, and an individual's illness may vary over time. Some symptoms may disappear, only to be replaced by new ones. Some people may have a relatively stable course, while others may fluctuate between times of severe symptoms and times of remission.
 

Prognosis

There is no treatment that cures fibromyalgia. Some people with FM improve, but total recovery is unlikely. A 2011 longitudinal study found a trend toward improvement in symptom severity overall, and 25% had at least moderte improvement of pain over time.

As with FM, there is no cure for ME/CFS. Both its course and severity vary greatly. A 2012 review of research reported that 17% to 64% of adults improved, 10% to 20% worsened over time and less than 10% recovered.

Though neither is curable at present, both fibromyalgia and ME/CFS can be treated. Medications and lifestyle adaptations can help reduce pain and discomfort, bring greater stability and lessen suffering.

[Note: For more detailed discussion of the two conditions, see the articles About Fibormyalgia and About ME/CFS.]