NeurologyPEM-relevant

Pain and Sensitization

240 studies in the atlas

Chronic pain is reported by a majority of ME/CFS patients, including headaches, muscle pain, joint pain, and widespread tenderness. Central sensitization — an amplification of pain signals by the nervous system — may contribute. The overlap with fibromyalgia is substantial, though the two conditions are considered distinct.

What we know

Chronic pain is reported by a majority of ME/CFS patients across multiple symptom domains
Substantial clinical overlap exists between ME/CFS and fibromyalgia, though they have distinct diagnostic criteria
Central sensitization mechanisms have been proposed based on pain processing studies
Pain symptoms often worsen during PEM episodes

What remains uncertain

Whether central sensitization in ME/CFS has the same mechanisms as in fibromyalgia
Small fiber neuropathy may contribute to pain in a subset of patients
Whether pain management approaches effective in fibromyalgia also help ME/CFS patients
The relationship between neuroinflammation and pain sensitization in ME/CFS

What is emerging

Whether pain subtypes exist within ME/CFS that respond to different treatments
The precise overlap and distinction between ME/CFS pain and fibromyalgia pain
Whether pain biomarkers can help distinguish ME/CFS from other chronic pain conditions
The role of glial cell activation in ME/CFS pain

Start here

E0 ConsensusPEM unclear

Interventions to treat pain in paediatric CFS/ME: a systematic review.

Ascough, Caitlin, King, Hayley, Serafimova, Teona et al.·BMJ paediatrics open·2020

This review looked at whether treatments for ME/CFS in children help reduce pain, which affects about two-thirds of young patients. Researchers searched medical databases for studies measuring pain before and after treatment. They found that most treatment studies didn't even measure pain, and the few that did weren't specifically designed to treat pain—they focused on overall ME/CFS management. The evidence suggests that children who recover from ME/CFS tend to have less pain than those who don't recover.

Pain and Sensitization

What we know

What remains uncertain

What is emerging

Interventions to treat pain in paediatric CFS/ME: a systematic review.

Research Momentum

Top Studies

Interventions to treat pain in paediatric CFS/ME: a systematic review.

Sleep, pain, fibromyalgia, and chronic fatigue syndrome.

A systematic scoping review and conceptual analysis of new-onset fibromyalgia manifestations after non-hospitalized COVID-19: empirics, definitions, methodologies, pathophysiology, mapping of literature, and knowledge gaps.

Effectiveness of Pain Neuroscience Education in Patients with Chronic Musculoskeletal Pain and Central Sensitization: A Systematic Review.

Identification of mental health and quality of life outcomes in primary care databases in the UK: a systematic review.

Pathophysiology of interstitial cystitis.

Are Traditional Remedies Useful in Management of Fibromyalgia and Chronic Fatigue Syndrome? A Review Study.

Neuroimaging of Central Sensitivity Syndromes: Key Insights from the Scientific Literature.

Dysfunctional syndromes and fibromyalgia: a 2012 critical digest.

The prevalence of fibromyalgia in other chronic pain conditions.

Systematic review of multi-symptom conditions in Gulf War veterans.

Genetic factors in neuromuscular pain.

Fibromyalgia syndrome, idiopathic widespread persistent pain or syndrome of myalgic encephalomyelopathy (SME): what is its nature?

Post-Lyme borreliosis syndrome: a meta-analysis of reported symptoms.

A systematic review on the health outcomes associated with non-endocarditis manifestations of chronic Q fever.

Chronic Pelvic Pain in Women.

Yoga intervention and functional pain syndromes: a selective review.

Gynecological disorders in bladder pain syndrome/interstitial cystitis patients.

Bladder pain syndrome/interstitial cystitis as a functional somatic syndrome.

[What happens to the fibromyalgia syndrome?].

Effects of Yijinjing Qigongin Alleviating Fatigue, Sleep Quality, and Health Status on Patients with Chronic Fatigue Syndrome: A Randomized, Controlled, and Parallel Group Clinical Study.

Muscle injections with lidocaine improve resting fatigue and pain in patients with chronic fatigue syndrome.

Acupuncture for chronic fatigue syndrome and idiopathic chronic fatigue: a multicenter, nonblinded, randomized controlled trial.

Pain in chronic fatigue syndrome: response to rehabilitative treatments in the PACE trial.

Isometric yoga improves the fatigue and pain of patients with chronic fatigue syndrome who are resistant to conventional therapy: a randomized, controlled trial.

Pain physiology education improves pain beliefs in patients with chronic fatigue syndrome compared with pacing and self-management education: a double-blind randomized controlled trial.

Prevalence of Chronic Overlapping Pain Conditions in Participants With Chronic Low Back Pain Enrolled in a Pragmatic Trial of Mindfulness-Based Stress Reduction.

Influence of Morphine and Naloxone on Pain Modulation in Rheumatoid Arthritis, Chronic Fatigue Syndrome/Fibromyalgia, and Controls: A Double-Blind, Randomized, Placebo-Controlled, Cross-Over Study.

A Randomized, Controlled Trial of Wholistic Hybrid Derived From Eye Movement Desensitization and Reprocessing and Emotional Freedom Technique (WHEE) for Self-Treatment of Pain, Depression, and Anxiety in Chronic Pain Patients.

Kinesiophobia and maladaptive coping strategies prevent improvements in pain catastrophizing following pain neuroscience education in fibromyalgia/chronic fatigue syndrome: An explorative study.

Does acetaminophen activate endogenous pain inhibition in chronic fatigue syndrome/fibromyalgia and rheumatoid arthritis? A double-blind randomized controlled cross-over trial.

Efficacy of aquatic vs land-based therapy for pain management in women with fibromyalgia: a randomised controlled trial.

Chronic Pain Prevalence, Characteristics, and Impact in United States Adults With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis.

The association of fatigue and pain with cognitive test performance in patients with myalgic encephalomyelitis/chronic fatigue syndrome.

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Impact on Quality of Life (QoL) of Persons with ME/CFS.

Dry eye symptoms and signs in United States Gulf War era veterans with myalgic encephalomyelitis/chronic fatigue syndrome.

The Significance of Pain Drawing as a Screening Tool for Cervicogenic Headache and Associated Symptoms in Chronic Fatigue.

Assessing sleep and pain among adults with myalgic encephalomyelitis/chronic fatigue syndrome: psychometric evaluation of the PROMIS® sleep and pain short forms.

Impact of Life Stressors on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Symptoms: An Australian Longitudinal Study.

Clinical Profile and Aspects of Differential Diagnosis in Patients with ME/CFS from Latvia.

Health, Wellbeing, and Prognosis of Australian Adolescents with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Case-Controlled Follow-Up Study.

High Prevalence of Perineural Cysts in Patients with Fibromyalgia and Chronic Fatigue Syndrome.

Health-related quality of life in patients with myalgic encephalomyelitis/chronic fatigue syndrome: an Australian cross-sectional study.

Longitudinal outcomes associated with significant other responses to chronic fatigue and pain.

Relationship Between Exercise-induced Oxidative Stress Changes and Parasympathetic Activity in Chronic Fatigue Syndrome: An Observational Study in Patients and Healthy Subjects.

Pain is associated with reduced quality of life and functional status in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Poor self-reported sleep quality and health-related quality of life in patients with chronic fatigue syndrome/myalgic encephalomyelitis.

Prefrontal Structure Varies as a Function of Pain Symptoms in Chronic Fatigue Syndrome.

Specialist treatment of chronic fatigue syndrome/ME: a cohort study among adult patients in England.

Binocular Vision in Chronic Fatigue Syndrome.

Pain in people with chronic fatigue syndrome/myalgic encephalomyelitis: the role of traumatic stress and coping strategies.

A Cross Cultural Comparison of Disability and Symptomatology Associated with CFS.

The Process of Change in Pain During Cognitive-Behavior Therapy for Chronic Fatigue Syndrome.

Increased Vulnerability to Pattern-Related Visual Stress in Myalgic Encephalomyelitis.

Pain and pressure pain thresholds in adolescents with chronic fatigue syndrome and healthy controls: a cross-sectional study.

Treatment outcome in adults with chronic fatigue syndrome: a prospective study in England based on the CFS/ME National Outcomes Database.

Self-critical perfectionism and its relationship to fatigue and pain in the daily flow of life in patients with chronic fatigue syndrome.

Cognitive performance is of clinical importance, but is unrelated to pain severity in women with chronic fatigue syndrome.

Role of psychological aspects in both chronic pain and in daily functioning in chronic fatigue syndrome: a prospective longitudinal study.

Dyspnea in Chronic Fatigue Syndrome (CFS): comparison of two prospective cross-sectional studies.