Mastaglia, Frank L · Neuromuscular disorders : NMD · 2012 · DOI
When muscles work hard, pain and fatigue often happen together and can make it harder to exercise. This review examines how pain and tiredness are connected in people with muscle disorders, and explores whether brain stimulation techniques might help reduce both symptoms. Researchers used special magnetic brain stimulation tools to study how the brain controls muscles during exhausting activity.
Understanding how pain and fatigue are connected at the brain and muscle level is crucial for ME/CFS patients, as many experience both symptoms simultaneously. This review identifies novel non-pharmacological approaches (brain stimulation) that could potentially reduce both pain and post-exertional malaise, and emphasizes the need for more research in fatiguing conditions similar to ME/CFS.
This is a review article, not a primary research study, so it does not present new experimental data or test interventions directly in patient populations. The review does not establish that brain stimulation techniques are effective in ME/CFS specifically—it calls for further investigation and notes the lack of existing evidence. It does not prove causation between pain and fatigue, only that they may co-occur and potentially share central nervous system mechanisms.
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
Mastaglia, Frank L (2012). The relationship between muscle pain and fatigue.. Neuromuscular disorders : NMD. https://doi.org/10.1016/j.nmd.2012.10.003
BibTeX
@article{mecfsatlas-mastaglia-2012-relationship-between,
author = {Mastaglia, Frank L},
title = {The relationship between muscle pain and fatigue.},
journal = {Neuromuscular disorders : NMD},
year = {2012},
doi = {10.1016/j.nmd.2012.10.003},
note = {PubMed: 23182635},
url = {https://www.mecfsatlas.com/evidence/mastaglia-2012-relationship-between},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/mastaglia-2012-relationship-between
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