Edwards, Charles C, Byrnes, Julia M, Broussard, Camille A et al. · Journal of translational medicine · 2025 · DOI
Researchers tested whether a simple arm position exercise (holding arms overhead and opening/closing fists) could trigger symptoms in ME/CFS patients who struggle with overhead activities. They found that nearly all patients (97%) developed arm symptoms like pain, numbness, or heaviness during the test, and 41% also experienced whole-body symptoms like dizziness, brain fog, or a racing heart. This suggests that some ME/CFS patients may have nerve compression issues in their shoulders or neck that worsen with certain arm positions.
Many ME/CFS patients report struggling with everyday activities like combing hair or reaching overhead, but this symptom has been understudied. This research suggests that nerve compression syndromes—which may be diagnosable and potentially treatable—could contribute to these difficulties. Identifying this subgroup could lead to targeted interventions and better understanding of ME/CFS heterogeneity.
This study does not establish that brachial plexus compression or thoracic outlet syndrome is common in the broader ME/CFS population, as it only enrolled patients who already reported overhead difficulties. It cannot determine causation or distinguish whether nerve compression causes systemic symptoms or is simply associated with them. The findings apply specifically to symptomatic adolescents and young adults and may not generalize to all ME/CFS patients.
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
Edwards, Charles C, Byrnes, Julia M, Broussard, Camille A, Azola, Alba M, Swope, Meghan E, Marden, Colleen L, et al. (2025). Provocation of brachial plexus and systemic symptoms during the elevated arm stress test in individuals with myalgic encephalomyelitis/chronic fatigue syndrome or idiopathic chronic fatigue.. Journal of translational medicine. https://doi.org/10.1186/s12967-025-06137-7
BibTeX
@article{mecfsatlas-edwards-2025-provocation-brachial,
author = {Edwards, Charles C and Byrnes, Julia M and Broussard, Camille A and Azola, Alba M and Swope, Meghan E and Marden, Colleen L and Swope, Renee L and Lum, Ying Wei and Violand, Richard L and Rowe, Peter C},
title = {Provocation of brachial plexus and systemic symptoms during the elevated arm stress test in individuals with myalgic encephalomyelitis/chronic fatigue syndrome or idiopathic chronic fatigue.},
journal = {Journal of translational medicine},
year = {2025},
doi = {10.1186/s12967-025-06137-7},
note = {PubMed: 39844172},
url = {https://www.mecfsatlas.com/evidence/edwards-2025-provocation-brachial},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/edwards-2025-provocation-brachial
Contribute
Private, reviewed by a human. Not a public comment thread.