Fibromyalgia and chronic fatigue share a number of factors in common and are often both diagnosed in the same individual. While there is little understanding of what causes either condition, treatment is available for both.
Fibromyalgia and chronic fatigue syndrome share a number of symptoms in common. Many experts speculate that diseases may have a common underlying pathology, even though no cause has been established for either disease. The limited evidence that does exist suggests that both conditions, even if not caused by the same underlying pathology, share at least several features in common including exacerbating and relieving factors.
Causes and Links
Both fibromyalgia and chronic fatigue syndrome fall under the category of chronic pain syndromes. According to Morris Papernik, a member of the U.S. Department of Health and Human Services Chronic Fatigue Syndrome Advisory Committed, chronic fatigue syndrome has a number of comorbidities. As he points out, “anytime you have a syndrome, you are going to have a lot of other illnesses that overlap.”
Both disorders have strong links to tension headaches, depression, panic attacks, post traumatic stress disorder, low back pain, temporomandibular joint pain, and irritable bowel syndrome. The key factor that links all of these conditions together is chronic pain that is relatively resistant to treatment with standard analgesics. A study published in the Archives of Internal Medicine in 2001 found that while only 18% of patients with fibromyalgia also carried a diagnosis of chronic fatigue, 64% actually met criteria for diagnosis. In other words, fibromyalgia and chronic fatigue syndrome may occur at the same time in up to 64% of patients, though only a fraction of those patients will be diagnosed with both conditions. The same study found links between temporomandibular joint pain and irritable bowel syndrome, indicating that as many as 92% of chronic fatigue syndrome patients and 77% of patients with fibromyalgia suffer from irritable bowel syndrome.
One of the most substantial links between fibromyalgia and chronic fatigue syndrome is disordered sleep. Patients suffering from both diseases complain of inadequate rest, insomnia, and increased pain during the nighttime hours. Additionally, both syndromes are highly responsive to improved sleep patterns including consistent hours for going to bed and waking up and avoidance of stimulating foods and activities prior to bed.
Dr. Papernik points out that a study of chronic fatigue patients revealed that they had shorter periods of uninterrupted sleep than the average person. This correlates quite well with similar studies in fibromyalgia. Dr. Papernik also points out that treating sleep problems can relieve many of the symptoms in both conditions.
Another substantial link between fibromyalgia and chronic fatigue is the complaint of cognitive deficits. Many patients complain of difficulty concentrating, memory loss, decreased attention, and the feeling as though they are “working in a brain fog.”
Both fibromyalgia and chronic fatigue syndrome seem to respond well to the same types of treatment. SSRIs and other antidepressants are the mainstays of treatment in both conditions. In addition to medication, fibromyalgia and chronic fatigue syndrome respond well to cognitive-behavioral therapy and exercise.
Exercise seems to be the single most important factor in the treatment of both conditions. While medications can help to reduce symptoms and get patients “over the hump,” exercise seems to have more beneficial long-term effects. The key to exercise in both conditions is to start slow and work up over time.
Diet and sensitivities to food also seem to play a role in both diseases. Unfortunately, the specific foods that will affect a given individual vary from one person to the next. This means that it is necessary for patients to maintain records of their diet in order to determine what foods exacerbate and relieve their symptoms.
Fibromyalgia and chronic fatigue syndrome share many features in common, though there is no understanding of what causes either condition. Attention to diet and dedication to exercise have both been found to have tremendous benefit and those who suffer from fibromyalgia and chronic fatigue syndrome.