Clauw, Daniel J · PM & R : the journal of injury, function, and rehabilitation · 2010 · DOI
This article explains that ME/CFS is a complex illness with roots in both the body and brain, involving several connected problems at the same time. Researchers have found that ME/CFS shares similar patterns with other conditions like fibromyalgia and irritable bowel syndrome, and involves issues with sleep, pain, cognitive problems, and extreme tiredness after activity. The article describes how inflammation, infection, problems with stress hormones, and nerve signal problems may all contribute to ME/CFS, though we don't yet know which problems matter most.
This perspective articulates ME/CFS as a legitimate medical condition with demonstrable biological abnormalities rather than a purely psychological disorder, validating patient experiences of physical symptoms. Understanding that ME/CFS shares mechanisms with other recognized somatic syndromes helps legitimize the condition and may guide development of targeted treatments addressing specific underlying abnormalities.
This editorial does not establish causation or definitively prove which biological abnormalities directly cause ME/CFS symptoms—it identifies associations and correlations. It does not present new experimental data or test specific therapeutic interventions, and cannot determine whether identified abnormalities are primary causes, secondary consequences, or contributing factors to the syndrome.
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
Clauw, Daniel J (2010). Perspectives on fatigue from the study of chronic fatigue syndrome and related conditions.. PM & R : the journal of injury, function, and rehabilitation. https://doi.org/10.1016/j.pmrj.2010.04.010
BibTeX
@article{mecfsatlas-clauw-2010-perspectives-fatigue,
author = {Clauw, Daniel J},
title = {Perspectives on fatigue from the study of chronic fatigue syndrome and related conditions.},
journal = {PM & R : the journal of injury, function, and rehabilitation},
year = {2010},
doi = {10.1016/j.pmrj.2010.04.010},
note = {PubMed: 20656623},
url = {https://www.mecfsatlas.com/evidence/clauw-2010-perspectives-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/clauw-2010-perspectives-fatigue
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