Borchers, Andrea T, Gershwin, M Eric · Clinical reviews in allergy & immunology · 2015 · DOI
Fibromyalgia is a condition that causes widespread pain, fatigue, and sleep problems, and it shares many symptoms with other conditions that are hard to diagnose. This review explains that while some people think fibromyalgia might be caused by infection, inflammation, or injury, there is not strong evidence supporting these ideas. The authors recommend that treatment should focus on education, exercise, physical therapy, and approved medications rather than opioids.
This review is relevant to ME/CFS patients because fibromyalgia and ME/CFS are often confused or co-occur, both being complex functional syndromes lacking clear biomarkers. Understanding what does NOT cause fibromyalgia (infection, trauma, inflammation) helps clarify the distinction between these conditions and informs appropriate treatment approaches. The emphasis on evidence-based, non-opioid management strategies applies to broader understanding of how to treat post-viral conditions like ME/CFS.
This editorial does not present new experimental data or clinical trial results; it is a narrative review synthesizing existing literature. The authors' conclusion that infectious and inflammatory causes lack support is based on their interpretation of existing evidence, not new mechanistic studies. The review does not establish what fibromyalgia IS caused by, only what it is not.
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 →
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