Fibromyalgia and chronic fatigue syndrome may look like the same condition, but they both have noticeable differences.
One opinion in the fibromyalgia/CFS debate claims that fibromyalgia and CFS are the same disorder with different personalities, others claim the conditions are entirely different, and still others believe that neither syndrome exists at all.
If you go to your primary care doctor and give them a list of your complaints – fatigue, trouble with memory, and vague aching in your muscles and joints, your primary care doctor will probably diagnose you with chronic fatigue syndrome. Why? Many doctors still use the 1994 international case definition for CFS, which was published by the Centers for Disease Control.
On the other hand, if your primary complaint is constant pain, and you consult a rheumatologist, you will be diagnosed with fibromyalgia based on tender points that are defined by the American College of Rheumatology (1990).
Both syndromes have overlapping disorders like irritable bowel syndrome, urinary incontinence, mitral valve prolapse, and temporomandibular dysfunction. You may also experience migraines, restless legs, myofascial pain syndrome, chemical sensitivities, and maybe hyperextensibility, acne rosacea, dry eyes and mouth and a constant runny nose with congestion.
Chronic fatigue syndrome is debilitating fatigue alongside muscular and joint pain, swollen glands, sore throat, and thinking issues. Fibromyalgia is characterized by muscle pain and sensitivity centered around tender points throughout the body.
Fibromyalgia and chronic fatigue syndrome are so similar that they are often confused with each other
Symptoms defined as debilitating fatigue, post-exertion malaise, sore throat, headache, joint aches and general weakness, swelling, and numbness, plus memory loss and depression, are a part of both conditions.
Both conditions share reduced cortical and midbrain blood flow. Neurotransmitters that send pain messages to the brain cause the debilitating pain in fibromyalgia, but not in CFS. A cellular antiviral enzyme is often elevated in CFS and causes pain. These are significant differences between the two conditions. In fibromyalgia, pain is caused by neurotransmitters, and in CFS pain is caused by antiviral enzymes.
Chronic fatigue syndrome is triggered by the flu, infectious illnesses, or maybe a trauma or surgery. Fibromyalgia is caused by trauma and rarely by an infection.
Treatment is usually just symptomatic therapy and supportive care. A good diet, supplements, management of sleep disorders and pain are the necessary treatments. Both fibromyalgia and chronic fatigue syndrome are treated with the same medications.
Often counseling is used as a coping mechanism for the stress and pain of both conditions, and with stress and pain, studies claim that low-level exercise is beneficial. If you choose to exercise with either syndrome, however, do pace yourself and stop when you are fatigued or sore.
Another difference between fibromyalgia and chronic fatigue syndrome is the exercise program that you should adopt in order to treat it. If you are diagnosed with fibromyalgia, your symptoms seem to do better with a progressive exercise program that is moderate to aggressive. With chronic fatigue syndrome, you need to take exercise at a slower pace.
Chronic fatigue syndrome and fibromyalgia are almost “Catch-22” based. If there is no complaint of muscle pain, you probably have chronic fatigue syndrome that is characterized by cognitive dysfunction, fatigue, sleep disorders, and flu-like symptoms. If your cognitive symptoms are minimal and you have widespread muscle pain, you probably have fibromyalgia. Studies say that almost 70 percent of those with chronic fatigue syndrome meet criteria for fibromyalgia, and about 70 percent of those with fibromyalgia also meet the criteria for chronic fatigue syndrome.
Both conditions mainly affect women
The similarities are:
- Reduced cerebral blood flow in cortex and midbrain
- HPG Axis suppression
- Sleep disorders
- Diminished serotonin
- Low growth hormone
- Familial aggregation/haplotypes
Both conditions mainly affect women, and they differ in the amount of pain and fatigue. The same medications, however, are used in both cases.
If you look at the conditions scientifically, things get even more confusing, but science proves that the two conditions are entirely different.
The main difference? Both diseases have a different cause
In chronic fatigue syndrome and fibromyalgia studies, researchers concentrated on the levels of BNDF (a nerve repair agent), or the glue that binds receptors between the neurons in your brain. BNDF is known to increase voltage and improve signal strength. It also activates cells that increase the production of more BDNF and other proteins like serotonin. Low levels of BDNF may cause depression and thoughts of suicide. In CFS these agents were less than 25 percent of normal. Such levels are the same levels found in patients with multiple sclerosis.
In fibromyalgia, BDNF levels could not be definitively determined. High levels of BDNF in fibromyalgia seems to enhance the activity of pain pathways, and you feel more pain.
Low levels of BDNF in chronic fatigue syndrome impede neuron repair and slow down nerve transmission (you still feel pain, but at a different level). Researchers ask the question, “Could, fibromyalgia be a disorder of brain excitation and chronic fatigue syndrome be a disorder of brain loss and slow functioning?”
Neither scenario sounds promising, does it? Studies clarify the similarities of fibromyalgia and chronic fatigue syndrome by stating that both conditions are characterized by a “sympathetic nervous system activation, increased lactate levels, reduced aerobic capacity, decreased cortisol, reduced brain blood flow, and a decrease in gray matter in the brainstem.”
Let’s put the similarities in lay terms. In both conditions, there is reduced heart rate variability and sympathetic nervous system activation. Both conditions cause reduced aerobic capacity, and both have lactate metabolism issues. Homocysteine is increased in spinal fluid, and reduced blood flow to the brain appears in both conditions.
Differences between fibromyalgia and chronic fatigue syndrome include substance P that is increased in fibromyalgia and reduced in chronic fatigue syndrome. BDNF is increased in fibromyalgia and reduced in chronic fatigue syndrome. There is an increase in IL-8 in fibromyalgia and a decrease in IL8 in chronic fatigue syndrome. Leptin is reduced in fibromyalgia and leptin is increased in chronic fatigue syndrome.
The significant difference? Pain is the predominant problem in fibromyalgia and fatigue is the primary complaint in those who have chronic fatigue syndrome. Another difference is how the pain is caused.
The pain of fibromyalgia is chronic and widespread and often associated with stiffness. Those who have fibromyalgia have tender points that cannot be touched.
Fatigue in chronic fatigue syndrome can be completely incapacitating. To be diagnosed with chronic fatigue syndrome, you need to have fatigue that is present for more than six months and is accompanied by a sore throat, tender lymph nodes, sleep issues, headaches, impaired memory, dizziness, and bowel complaints, plus anxiety or depression.
The approaches to treating the two disorders are similar. Most patients benefit from taking anti-depressants, pain relievers, and sleep aids. Try changing your diet as well as doing low-impact aerobic exercise.
Chronic fatigue syndrome and fibromyalgia are separate but related. Fibromyalgia and chronic fatigue syndrome share common symptoms of severe fatigue and pain that interfere with patients' daily lives. The lack of deep and restorative sleep is a huge part of the problems with these two conditions. Lack of sleep contributes to pain and pain causes sleep disorders.
No matter what condition you have, fibromyalgia or chronic fatigue syndrome, you need to get help and treatment from a medical doctor, as well as a therapist and a support group. You can also gently fight either condition by following your body’s symptoms.