I am so confused right now (nothing unusual). Can a person with Chronic Fatigue not also have Fibromyalgia? I was reading an abstract regarding "diffferential diagnosis" and CFS/ME that someone here had a link to at http://emedicine.medscape.com/article/235980-diagnosis The author states that Fibromyalgia does not cause cognitive defects, so it is readily differentiated from CFS. Furthermore, patients with CFS do not have trigger points, which are characteristic of fibromyalgia. (Fibromyalgia definately does cause cognitive difficulties, so at least that part is wrong.) I got this summary of the Canadian Criteria for Chronic Fatigue from about.com. Canadian Diagnostic Criteria for Chronic Fatigue From the Canadian Consensus Document: A patient with ME/CFS will meet the criteria for fatigue, post-exertional malaise and/or fatigue, sleep dysfunction, and pain; have two or more neurological/cognitive manifestations and one or more symptoms from two of the categories of autonomic, neuroendocrine, and immune manifestations; and adhere to item 7 [below]. 1. Fatigue The patient must have a significant degree of new onset, unexplained, persistent, or recurrent physical and mental fatigue that substantially reduces activity level. 2. Post-Exertional Malaise and/or Fatigue An inappropriate loss of physical and mental stamina, rapid muscular and cognitive fatigability, post-exertional malaise and/or fatigue and/or pain and a tendency for other symptoms to worsen. The recovery period is pathologically slow -- usually 24 hours or longer. 3. Sleep Dysfunction Unrefreshing sleep or sleep quality, or rhythm disturbances such as reversed or chaotic sleep rhythms. 4. Pain A significant degree of pain, which can be in the muscles and/or joints, and is often widespread and migratory. Often, there are headaches of a new type, pattern or severity. 5. Two or more of the following neurological/cognitive manifestations: Confusion Impairment of concentration and short-term memory consolidation Disorientation Difficulty with information processing Categorizing and word retrieval Perceptual and sensory disturbances (such as spatial instability and disorientation, inability to focus vision) Ataxia (inability to coordinate muscular movement), muscle weakness or twitching Cognitive, sensory or emotional overload, which may cause a crash or anxiety 6. At least 1 symptom from two of the following categories: Autonomic manifestations, including: neurally mediated hypotension, postural orthostatic tachycardia syndrome, delayed postural hypotension, light-headedness, pallor, nausea and irritable bowel syndrome, urinary frequency and bladder dysfunction, palpitations with or without cardiac arrhythmias, exertional dyspnea (difficult or labored breathing) Neuroendocrine manifestations, including: subnormal body temperature and marked temperature fluctuation, sweating episodes, recurrent feelings of feverishness and cold extremities, intolerance of extreme heat or cold, marked weight change (anorexia or abnormal appetite), loss of adaptability and worsening of symptoms with stress Immune manifestations, including: tender lymph nodes, recurrent sore throat, recurrent flu-like symptoms, general malaise, or new sensitivities to food, medications and/or chemicals. 7. Illness persists for at least 6 months Onset is usually distinct but may be gradual. In children, only 3 months is needed for a diagnosis. The criteria also state that a small number of patients have no pain or sleep dysfunction but fit no other diagnosis. Those people can be diagnosed with ME/CFS if they had an infectious illness at onset. These criteria are from the Canadian Consensus Document, which also offers objective measures and biomarkers for doctors to follow and recommends treatments. This is a summary of Fibromyalgia symptoms from the National Fibromyalgia Association Pain The pain of fibromyalgia is profound, chronic and widespread. It can migrate to all parts of the body and vary in intensity. FM pain has been described as stabbing and shooting pain and deep muscular aching, throbbing, and twitching. Neurological complaints such as numbness, tingling, and burning are often present and add to the discomfort of the patient. The severity of the pain and stiffness is often worse in the morning. Aggravating factors that affect pain include cold/humid weather, non-restorative sleep, physical and mental fatigue, excessive physical activity, physical inactivity, anxiety and stress. Fatigue In today's world many people complain of fatigue; however, the fatigue of FM is much more than being tired after a particularly busy day or after a sleepless night. The fatigue of FM is an all-encompassing exhaustion that can interfere with occupational, personal, social or educational activities. Symptoms include profound exhaustion and poor stamina Sleep problems Many fibromyalgia patients have an associated sleep disorder that prevents them from getting deep, restful, restorative sleep. Medical researchers have documented specific and distinctive abnormalities in the Stage 4 deep sleep of FM patients. During sleep, individuals with FM are constantly interrupted by bursts of awake-like brain activity, limiting the amount of time they spend in deep sleep. Other symptoms/overlapping conditions Additional symptoms may include: irritable bowel and bladder, headaches and migraines, restless legs syndrome (periodic limb movement disorder), impaired memory and concentration, skin sensitivities and rashes, dry eyes and mouth, anxiety, depression, ringing in the ears, dizziness, vision problems, Raynaud's Syndrome, neurological symptoms, and impaired coordination. Some websites include more information on circulation problems with FMS. They state that blood flow remains in the abdomen area and does not circulate like it should to the limbs (especially to the hands and feet). There is a name for this, but I cannot find it right now. The two are so similar, but are also different. Could it be possible they are both caused by the same thing? Why do some doctors lump them together? If they are caused by something different, is it possible to have both illnesses at the same time?