Luchting, Benjamin, Behrends, Uta, Eigner, Bianca et al. · Schmerz (Berlin, Germany) · 2024 · DOI
Standard pain therapy programs often push patients to gradually increase their activity levels, but this approach can be harmful for people with ME/CFS because of postexertional malaise (PEM)—a worsening of symptoms after physical or mental effort. This paper reviews how pain therapy should be redesigned specifically for ME/CFS patients and presents a new model clinic program that carefully adjusts treatment to each person's individual tolerance levels to avoid triggering symptom flares.
ME/CFS patients commonly experience pain, yet existing pain therapy frameworks can worsen their condition through inappropriate activity escalation. This work addresses a critical gap by proposing treatment modifications that respect post-exertional malaise, potentially improving access to evidence-based pain management without iatrogenic harm.
This study does not provide empirical evidence that the proposed model actually improves pain outcomes or is superior to existing approaches—it presents a conceptual framework only. It does not establish efficacy through randomized controlled trials or quantitative outcome comparisons, and does not prove that individualized pacing prevents PEM in a pain therapy context.
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
Luchting, Benjamin, Behrends, Uta, Eigner, Bianca, Stojanov, Silvia, Warlitz, Cordula, Haegele, Matthias, et al. (2024). [Interdisciplinary multimodal pain therapy in postviral syndromes and ME/CFS : Features, pitfalls and model concept].. Schmerz (Berlin, Germany). https://doi.org/10.1007/s00482-023-00761-2
BibTeX
@article{mecfsatlas-luchting-2024-interdisciplinary-multimodal,
author = {Luchting, Benjamin and Behrends, Uta and Eigner, Bianca and Stojanov, Silvia and Warlitz, Cordula and Haegele, Matthias and Neuwirth, Eva and Mihatsch, Lorenz and Richter, Hans Peter},
title = {[Interdisciplinary multimodal pain therapy in postviral syndromes and ME/CFS : Features, pitfalls and model concept].},
journal = {Schmerz (Berlin, Germany)},
year = {2024},
doi = {10.1007/s00482-023-00761-2},
note = {PubMed: 37864020},
url = {https://www.mecfsatlas.com/evidence/luchting-2024-interdisciplinary-multimodal},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/luchting-2024-interdisciplinary-multimodal
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