Fibromyalgia & Chronic Fatigue Syndrome

Reviewed By:
Vikas Garg, M.D., MSA

Aches and pains with no obvious cause? Constantly tired despite getting plenty of rest? If you answer yes to either question, you may have fibromyalgia or chronic fatigue syndrome. Or possibly both.

Fibromyalgia and chronic fatigue syndrome are two conditions characterized by their difficulties: difficult to diagnose, treat, deal with and, for some patients, even to prove they exist.

Fibromyalgia causes chronic widespread pain and multiple tender areas known as trigger points. Patients also often experience insomnia, fatigue, headaches, memory difficulties, depression and other symptoms.

Chronic fatigue syndrome (CFS) is marked by profound, long-lasting fatigue. Patients rest but cannot shake the overwhelming feelings of tiredness. There also other symptoms, such as impaired memory, sore throat, tender lymph nodes and muscle or joint pain. These patients usually wake up feeling tired and fatigued in the morning.

Both syndromes are more common in women than in men. And in each condition, the cause is unknown.

Differences and similarities

So what are the differences between fibromyalgia and chronic fatigue syndrome? It depends on whom you ask.

Some experts think they might be two names for the same condition. Between 50 and 70 percent of people diagnosed with one condition could just as easily be diagnosed with the other, according to the Arthritis Foundation.

In fact, a physician's familiarity with each disorder may influence the eventual diagnosis. For example, a doctor with a long history of treating fibromyalgia is more likely to diagnose this condition than CFS.

The National Institutes of Health says that CFS should not be diagnosed if a patient has a similar condition such as fibromyalgia, unless that condition has been adequately treated and would no longer be causing fatigue and other symptoms. However, some doctors may choose to make a dual diagnosis of CFS and fibromyalgia.

Though the two conditions share many symptoms (such as sleep problems and cognitive disturbances) some small but crucial distinctions can be made. Those distinctions may be summarized as fatigue or pain. Most patients have one symptom more than the other. For example:

• Pain is a more prominent feature of fibromyalgia than CFS. Injuries and trauma (physical or emotional) may trigger fibromyalgia. Chemicals that help the body transmit and interpret pain signals may not be present at normal levels in fibromyalgia patients.
  
  
• Fatigue is a more prominent feature of CFS. A flu-like illness often precedes CFS symptoms, and patients with this condition are less likely than patients with fibromyalgia to have individual tender areas on their bodies.

Of the two conditions, fibromyalgia is more readily acknowledged as a legitimate condition by the medical community. The nature of CFS remains controversial, with disagreement over its definition, diagnosis and treatment. Some doctors may still not even recognize CFS as a legitimate disorder, but recent research shows it has a biological basis.

Treatment options

Because fibromyalgia and chronic fatigue syndrome are so similar, they share many treatments. These include:

• Exercise therapy. Steady, gradual exercise is typically recommended. Patients may use a combination of aerobic, strength training and flexibility exercises. Experts such as physical therapists may devise an appropriate exercise program, and teach patients how to recognize when they should be active and when they need to rest.
  
  
• Medications. Drugs may be used to treat pain, depression, fatigue and other symptoms. Such medications include nonsteroidal anti-inflammatory drugs (NSAIDs, such as aspirin), analgesics and antidepressants. One drug, an anticonvulsant, has been approved specifically to treat fibromyalgia. Sometimes medication may be causing symptoms, so it's good to talk to your doctor about possible side effects of the drug.
  
  
• Cognitive behavioral therapy. This treatment has been shown to help fibromyalgia and CFS patients cope with their symptoms. This therapy helps patients stay positive and increase activity.
  
  
• Stress management and relaxation therapy. Classes, support groups and other methods can help patients reduce stress and insomnia, both of which can worsen fibromyalgia symptoms. Biofeedback (in which patients use their minds to control symptoms in their bodies) and massage therapy also can help.

If you experience chronic pain or fatigue, consult your physician. Diagnosis and treatment can significantly reduce symptoms associated with these syndromes.