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Post-Exertional Malaise in Patients with ME and CFS with Comorbid Fibromyalgia

Discussion in 'Latest ME/CFS Research' started by Kati, Jun 14, 2017.

  1. Kati

    Kati Patient in training

    Post-Exertional Malaise in Patients with ME and CFS with Comorbid Fibromyalgia.
    McManimen SL1, Jason LA1.
    Author information
    1Center for Community Research, DePaul University, 990 W Fullerton Avenue, Suite 3100, Chicago, IL USA.
    Myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) share some similar symptoms with fibromyalgia (FM). Prior research has found increased illness severity when patients have FM that is comorbid with ME and CFS. For example, post-exertional malaise (PEM) has been shown to be more severe in those with comorbid FM. However, PEM can be separated into two factors, Muscle and General PEM. It is unknown if the more severe PEM findings in comorbid FM are due to the Muscle or General PEM factor.

    The purpose of this study was to determine if the PEM differences seen between patients with and without comorbid FM exist for the Muscle or General PEM factors.

    An international convenience sample was collected via an online questionnaire. The questionnaire assessed the frequency and severity of several PEM-related symptoms. Additionally, participants provided information regarding the course and characteristics of their illness.

    Participants that indicated a comorbid diagnosis of FM displayed significantly more frequent and severe PEM symptoms in the Muscle and General PEM factors. The FM group also indicated significantly worse physical functioning compared to the group without comorbid FM.

    The secondary diagnosis of FM in addition to ME and CFS appears to amplify the PEM symptomatology and worsen patients' physical functioning. The findings of this study have notable implications on the inclusion of patients with comorbid FM in ME and CFS research studies.

    Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/28603794
  2. trishrhymes

    trishrhymes Senior Member

    Interesting article.

    I find it hard to know whether I have FM as well as ME. I certainly have a lot of muscle pain and some years ago was tested at the trigger points by a rheumatology OT who said I had FM. At what level of pain does the muscle pain many of us suffer as part of our ME, tip over into pain sufficiently bad to be classed as FM?

    And at what level does the exhaustion and post activity increase in pain in FM sufferers tip over into PEM and become ME - I'm guessing that would depend on whether they have other symptoms that fit the ME definitions as well as their muscle pain.

    I can see that it's relatively straightforward to distinguish the two if you have PEM and lots of symptoms, but no muscle pain then that would be ME, and if you have lots of muscle pain but no PEM or other ME symptoms, that would be FM.

    It may be that it's a continuum with ME at one end and FM at the other, and some of us in the overlap region where we have symptoms of both.

    Can anyone enlighten me?

    Perhaps we'll just have to wait for biomedical tests for both conditions, so we can each discover which category we belong to.
    ljimbo423, Kati and ScottTriGuy like this.
  3. ljimbo423

    ljimbo423 Senior Member

    United States, New Hampshire
    I don't know where that line is, but I think it's a very fuzzy one.:) My feeling is that both ME and FM are different manifestations of the same illness, they just present differently. I have both and have since I first got cfs.

    That sounds like a really good way to describe it!!
  4. RogerBlack

    RogerBlack Senior Member


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