E0 ConsensusPreliminaryPEM not requiredEditorialPeer-reviewedReviewed
Standard · 3 min
Fibromyalgia, chronic fatigue, and myofascial pain syndromes.
Goldenberg, D L · Current opinion in rheumatology · 1992
Quick Summary
This review examined research published on fibromyalgia and chronic fatigue syndrome, looking at what treatments work best and how these conditions are diagnosed. Researchers found that while many studies have been done, no single treatment has proven highly effective for either condition, and the way doctors diagnose chronic fatigue syndrome needs to be improved and made more consistent.
Why It Matters
This work highlights a critical gap in ME/CFS research: the lack of effective treatments and inconsistent diagnostic criteria that complicate both clinical practice and research comparison across studies. Establishing uniform diagnostic standards is essential for identifying which treatments truly work and understanding how ME/CFS relates to fibromyalgia and myofascial pain.
Observed Findings
No single therapy has demonstrated high effectiveness for fibromyalgia or chronic fatigue syndrome
Multiple randomized clinical trials using operational diagnostic criteria have been published in recent literature
The existing chronic fatigue syndrome case definition has significant weaknesses and has faced criticism
Substantial overlap exists among fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome
Inferred Conclusions
Current diagnostic criteria for chronic fatigue syndrome require revision to improve accuracy and consistency
Development of uniform diagnostic criteria is necessary to properly study the distinctions and overlaps between these three syndromes
Therapeutic approaches in these conditions need to be reconsidered or refined given the lack of proven efficacy
Better understanding of these conditions' relationships will improve both diagnosis and treatment strategies
Remaining Questions
What specific revisions to diagnostic criteria would best capture chronic fatigue syndrome cases?
Are there subgroups within these conditions that might respond differently to particular treatments?
What This Study Does Not Prove
This review does not establish which specific treatments might be effective—only that existing therapies at the time had limited success. It also does not prove that fibromyalgia, chronic fatigue syndrome, and myofascial pain are the same condition, only that their overlap requires further investigation with better diagnostic criteria.
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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