From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history
1-Muscles 2-Joints 3-Headaches 4-Lymph nodes
5-Abdominal 6-Sore throat 7-Eyes 8-Chest pain
Data from: Institute of Medicine 2015 (CDC, Jason et al. 2013b)

Pain in medical diagnosis is regarded as a symptom of an underlying condition. 

Pain in ME/CFS[edit | edit source]

Pain occurs in a wide range of forms in ME/CFS and is typically chronic. These include:

Pain can also occur as a consequence of commonly comorbid illnesses such as migraine, myofascial pain syndrome (MPS), temporomandibular joint syndrome (TMJ), interstitial cystitis, Raynaud's phenomenon, IBS, or from fibromyalgia, which is considered an overlapping syndrome.[1][3]

Pain in fibromyalgia[edit | edit source]

Researchers believe that fibromyalgia (FM) amplifies painful sensations by affecting the way your brain processes pain signals.[4]

Pain in fibromyalgia is commonly referred to as chronic widespread pain (CWP) that is otherwise unexplained, meaning not caused by another medical condition.

Fibromyalgia pain is assessed by a combination of location and frequency: pain must be present at least weekly in each pain location that is counted. Besides pain, additional fibromyalgia symptoms are also required.[5]

Widespread Pain Index[edit | edit source]

Before 2010, a tender point examination was needed to that assessed pain on pressure, but this has now been replaced by the more accurate Widespread Pain Index (WPI). The WPI scores pain in 19 locations:

  • Shoulder girdle - left and right
  • Hip (buttock, trochanter) - left and right
  • Jaw - left and right
  • Upper arm - left and right
  • Upper leg - left and right
  • Lower arm - left and right
  • Lower leg - left and right
  • Upper back
  • Lower back
  • Chest
  • Neck
  • Abdomen

Pain in fibromyalgia must not be explained by another medical condition, and must persist for at least three months, and exist in addition to a combination of other symptoms.[5]

Pain types[edit | edit source]

Types of pain commonly reported in fibromyalgia include:

irritable bowel syndrome, muscle weakness, headache, numbness/tingling, heartburn, painful urination, and bladder spasms

Many people with fibromyalgia will have other painful comorbid conditions such as:

Symptom recognition[edit | edit source]

  • In the Canadian Consensus Criteria, pain is a required criteria for diagnosis. It requires that "there is a significant degree of myalgia. Pain can be experienced in the muscles, and/or joints, and is often widespread and migratory in nature. Often there are significant headaches of new type, pattern or severity."[3][7]:8

Pain is an optional neurological criteria in the International Consensus Criteria, with many different types of pain recognized.[1]

The older Fukuda criteria for chronic fatigue syndrome (1994) recognized sore throat, tender cervical or axillary lymp nodes, headaches and other types of pain but did not require them for diagnosis.[2]

Recording pain[edit | edit source]

The primer for the International Consensus Criteria for ME includes a pain chart and the visual-analogue pain scale.[1]

Notable studies[edit | edit source]

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 1.4 Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Gerken, A; Jo, D; Lewis, DP; Light, AR; Light, KC; Marshall-Gradisnik, S; McLaren-Howard, J; Mena, I; Miwa, K; Murovska, M; Stevens, SR (2012), Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners (PDF), ISBN 978-0-9739335-3-6
  2. 2.0 2.1 Fukuda, K.; Straus, S.E.; Hickie, I.; Sharpe, M.C.; Dobbins, J.G.; Komaroff, A. (December 15, 1994). "The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group" (PDF). Annals of Internal Medicine. American College of Physicians. 121 (12): 953–959. ISSN 0003-4819. PMID 7978722.
  3. 3.0 3.1 Carruthers, Bruce M.; Jain, Anil Kumar; De Meirleir, Kenny L.; Peterson, Daniel L.; Klimas, Nancy G.; Lerner, A. Martin; Bested, Alison C.; Flor-Henry, Pierre; Joshi, Pradip; Powles, AC Peter; Sherkey, Jeffrey A.; van de Sande, Marjorie I. (2003), "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols" (PDF), Journal of Chronic Fatigue Syndrome, 11 (2): 7–115, doi:10.1300/J092v11n01_02
  4. 4.0 4.1 "Fibromyalgia - Symptoms and causes". Mayo Clinic. Retrieved May 3, 2019.
  5. 5.0 5.1 5.2 Wolfe, Frederick; Clauw, Daniel; Fitzcharles, Mary-Ann; Goldenberg, Don; Katz, Robert; Mease, Philip; Russel, Anthony; Russel, I. Jon; Winfield, John; Yunus, Muhammad (May 2010). "American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia" (PDF). Arthritis Care & Research (PDF). 62 (5): 600–610. doi:10.1002/acr.20140.
  6. Mann, Denise (September 7, 2011). "7 Conditions Linked to Fibromyalgia". Retrieved May 3, 2019.
  7. A Clinical Case Definition and Guidelines for Medical Practitioners: An Overview of the Canadian Consensus Document (2005).