Ascough, Caitlin, King, Hayley, Serafimova, Teona et al. · BMJ paediatrics open · 2020 · DOI
This review looked at whether treatments for ME/CFS in children help reduce pain, which affects about two-thirds of young patients. Researchers searched medical databases for studies measuring pain before and after treatment. They found that most treatment studies didn't even measure pain, and the few that did weren't specifically designed to treat pain—they focused on overall ME/CFS management. The evidence suggests that children who recover from ME/CFS tend to have less pain than those who don't recover.
Pain is a major burden affecting two-thirds of children with ME/CFS and correlates with increased fatigue and functional impairment, yet this systematic review reveals a striking gap in pain-focused treatment research. Understanding whether pain in paediatric ME/CFS requires targeted intervention versus resolution through general treatment is critical for developing effective clinical management strategies. This work highlights an urgent evidence gap that, if addressed, could improve quality of life for a substantial proportion of affected young people.
This review does not establish whether pain-specific interventions would be effective, as none were studied. The association between recovery and reduced pain does not prove that treatments causing recovery directly cause pain reduction—pain may improve as a secondary consequence of overall functional improvement. The limited number of qualifying studies prevents definitive conclusions about any particular treatment approach for paediatric ME/CFS pain.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Ascough, Caitlin, King, Hayley, Serafimova, Teona, Beasant, Lucy, Jackson, Sophie, Baldock, Luke, et al. (2020). Interventions to treat pain in paediatric CFS/ME: a systematic review.. BMJ paediatrics open. https://doi.org/10.1136/bmjpo-2019-000617
BibTeX
@article{mecfsatlas-ascough-2020-interventions-treat,
author = {Ascough, Caitlin and King, Hayley and Serafimova, Teona and Beasant, Lucy and Jackson, Sophie and Baldock, Luke and Pickering, Anthony Edward and Brooks, Jonathan and Crawley, Esther},
title = {Interventions to treat pain in paediatric CFS/ME: a systematic review.},
journal = {BMJ paediatrics open},
year = {2020},
doi = {10.1136/bmjpo-2019-000617},
note = {PubMed: 32201745},
url = {https://www.mecfsatlas.com/evidence/ascough-2020-interventions-treat},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/ascough-2020-interventions-treat
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