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Chronic Fatigue Syndrome (Fibromyalgia)

Chronic Fatigue Syndrome is characterized by debilitating fatigue, experienced as exhaustion, poor stamina, neurological problems, and a variety of flu-like symptoms. The illness is also known as chronic fatigue immune dysfunction syndrome (CFIDS), and in the United Kingdom as myalgic encephalomyelitis (ME). Chronic Fatigue Syndrome is also mistaken for Fibromyalgia which is a chronic musculoskeletal syndrome. Pain is generally accompanied by sleep disorders, fatigue, gastrointestinal disorders, and depression.

Chronic Fatigue Syndrome:

For many people, CFS begins after a cold, bronchitis, hepatitis, or an intestinal problem. For some, it follows a bout of infectious mononucleosis, or mono, which temporarily saps the energy of many teenagers and young adults. Often, people say that their illnesses started during a period of high stress. In others, CFS develops more gradually, with no clear illness or other event starting it.

Unlike flu symptoms, which usually go away in a few days or weeks, CFS symptoms either hang on or come and go frequently for more than six months.

Chronic Fatigue Syndrome Symptoms include:

Tender Lymph Nodes.
Fatigue and Weakness.
Muscle and Joint Aches.
Inability to Concentrate.

Fibromyalgia Symptoms include:

Pain is the primary symptom, found in virtually 100% of cases— specifically, pain and tenderness in certain areas of the body when pressure is applied to them. These areas include:

Back of the Head.
Upper Back.
Upper Chest.

Associated Features:

Chronic Fatigue Syndrome

Sleep Disorders.
Gastrointestinal Disorders.


Sleep Disorders - Restless Leg Syndrome, Sleep Apnea.
Gastrointestinal - Pain, bloating, wind, cramps.
Numbness or tingling sensations.
Chronic Headaches.
Heightened sensitivity to odours, loud noises, bright lights.
Painful Menstrual Periods and Painful Sexual Intercourse - Dyspareunia.
Frequent Urination.
Rapid or irregular heart rate, and shortness of breath.
Sensation of swelling in the hands and feet, even though swelling is not present.

Differential Diagnosis: 

Some disorders have similar symptoms. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.

Flu (viral Infection).


Chronic Fatigue Syndrome

The cause of Chronic Fatigue Syndrome is not yet known. Current theories are looking at the possibilities of neuroendocrine dysfunction, viruses, environmental toxins, genetic predisposition, or a combination of these.


Causes of fibromyalgia are not known. The condition produces vague symptoms that may be associated with diminished blood flow to certain parts of the brain. Clinicians have identified several other possible causes, including the following:

Autonomic nervous system dysfunction.
Chronic sleep disorders.
Emotional stress or trauma.
Immune or endocrine system dysfunction.
Upper spinal cord injury.
Viral or bacterial infection.


Chronic Fatigue Syndrome

Since no cause for CFS has been identified and the pathophysiology remains unknown, treatment programs are directed at relief of symptoms, with the goal of the patient regaining some level of pre-existing function and well-being. Although desirable, a rapid return to pre-illness health may not be realistic, and patients who expect this prompt recovery and do not experience it may exacerbate their symptoms because of overexertion, become frustrated


The goal of treatment is to reduce pain, improve sleep, and relieve associated symptoms. Treatment is tailored to the individual. Some patients experience significant relief of symptoms, some find moderate improvement, and others report little or no relief. Only about 5% of fibromyalgia patients become symptom free. Most treatment regimens include medication, lifestyle changes, exercise, physical therapy, and behavior modification

Counseling and Psychotherapy [ See Therapy Section ]:

Learning about what CFS is and what it is not is a critical component of therapy. This approach includes learning how to adjust activities and behaviors that may aggravate the illness. A formal method to impart this information is known as cognitive behavioral therapy. Cognitive behavioral therapy has been shown to facilitate patient coping and to allow increased activities without triggering increased symptoms.

Pharmacotherapy [ See Psychopharmacology Section ] :

Pharmacologic therapy is directed toward the relief of specific symptoms experienced by the individual patient.


DSM Code


G93.3 Chronic Fatigue Syndrome

Disorder Sheets

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Recommended Book

Chronic Fatigue Syndrome - The Hidden Epidemic - Click Here to View


Chronic Fatigue Syndrome (Fibromyalgia)

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Chronic Fatigue Syndrome