About Myalgic Encephalomyelitis and Fibromyalgia
Myalgic = muscle pain
Encephalo = brain
Myel = central nervous system
Itis = inflammation
Classified by the World Health Organization as a disease of the nervous system. ME is the subject of research by the Centers for Disease Control in the US and top researchers around the world.
- Chronic Fatigue Syndrome (CFS)
- Post-Viral Immune Dysfunction Syndrome (PVFS)
- Chronic Fatigue Immune Dysfunction Syndrome (CFDS)
Fibro = joint
Myalgia = muscle pain
Classified by the World Health Organization as a disease of the musculoskeletal system. Thought by many researchers to be a condition the same as, or related to ME.
What causes ME/CFS and FM?
The cause has not yet been identified. On-going research suggest that an infectious agent (possibly a virus) or other triggers invade brain and muscle cells, causing the immune system in some people to become chronically overactive.
Who, When and How Long?
ME and FM can be contracted by anyone at any age. A small minority of people recover completely, some experience a series of relapses and remissions, while in others the symptoms may persist for many years. An early and accurate diagnosis with immediate and appropriate treatment measures greatly enhances the chances for recovery.
The type, severity, and frequency of symptoms of ME and FM vary from one individual to another and often from day to day.
Clinical Definitions and Symptoms
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS) is a serious and complex illness that affects many of the body's systems. The prime indicating factor of ME/CFS is a debilitating pathological exhaustion that is not reversed by rest of any degree. This condition substantially reduces previous levels of activity and has a profound effect on the patient's quality of life. At least 100,000 Canadians are affected by ME/CFS. In order to be clinically diagnosed with CFS, an individual must meet both of the following criteria:
- Clinically evaluated, unexplained persistent or relapsing chronic fatigue that is of new of definite onset, is not the result of ongoing exertion, is not substantially alleviated by rest and results in substantial reduction of previous levels of occupational, educational, social or personal activities
- Four or more of the following key symptoms are concurrently present for 6 months or longer:
- Debilitating fatigue lasting at least 6 months, limiting activities by at least 50 per cent
- Low-grade fevers, recurring flu-like illness with chronic sore throat
- Gastro-intestinal problems
- Worsening of pre-existing allergies
- Immune system irregularities
- Substantial impairment in short-term memory or concentration (attention deficit, memory lapses, frequently using the wrong word, spatial disorientation)
- Sore throat
- Extreme joint and muscle pain without swelling or redness
- Headaches of a new type, pattern or severity
- Unrefreshing sleep (hypersomnia or insomnia, nightmares)
- Painful lymph nodes
- Post-exertional malaise lasting more than 24 hours
Profound exhaustion, which is the hallmark of the disorder, can come on suddenly or gradually and recurs or persists throughout the period of illness. Unlike the short-term disability of an acute infection, ME/CFS symptoms linger for at least 6 months and often for years.
In approximately one-third of cases, the sudden onset occurs following a respiratory, gastrointestinal, or other acute infection with symptoms that are flu-like. Emotional or physical traumas such as surgery or bereavement can also be precursors to development of ME/CFS.
Fibromyalgia (FM) affects a minimum of 600,000 people in Canada. The main symptoms of FM are chronic widespread pain, and profound fatigue. In order for a clinical diagnosis of FM to be made, an individual must have:
- Widespread pain in all four quadrants of their body for a minimum of 3 months
- At least 11 of the 18 specified tender points clustered around the neck, shoulder, chest, hip, knee, and elbow regions. Over 75 other tender points to have been found to exist but are not used for diagnostic purposes.
There is an 88% accuracy rate in the ability of the selection criteria to identify patients with FM. Some other common health problems associated with FM include:
- Sleep disorder
- Chronic headaches
- Gastro-intestinal problems
- Worsening of pre-existing allergies
- Irritable bowel syndrome
- Irritable bladder
- Cognitive and memory impairment
- Nerve irritation
- Reduced co-ordination
- Multiple chemical sensitivity (medications, foods, bright lights, noise, odours, cigarette smoke, exhaust fumes)
- Temporo-mandibular joint dysfunction syndrome often referred to as TMJ
- Muscle spasms
Some other common symptoms which tend to accompany FM are; chest pain (not related to heart disease), morning stiffness, numbness and tingling sensations, muscle twitching, the feeling of swollen extremities, skin sensitivities, dry eyes and mouth, frequent changes in eye prescription, and dizziness.
Some aggravating factors are; weather changes, cold or drafty environments, hormonal fluctuations, stress, depression. Anxiety and over-exertion can all contribute to symptom flare-ups.
Researchers in this field have noted a significant overlap between ME/CFS and FM. Chief of Rheumatology at Newton-Wellesley Hospital in Massachusetts, Dr. Don Goldberg, recently indicated that the clinical overlap between ME/CFS and FM is so great that a patient's diagnosis may depend on what the patient tells his/her doctor with regard to the apparent trigger of the illness, their own perception of it, and on the type of doctor the patient initially visits. Studies of sleep abnormalities, physiology, blood flow to the brain, cognitive dysfunction, growth hormones, stress etc., have noted numerous similarities between ME/CFS and FM.
What can be done?
To date the cure remains unknown. The following suggestions may help alleviate some symptoms.
- Rest (but avoid complete bed rest if possible).
- Take one day at a time.
- Educate yourself, your family, friends and physician about ME and FM.
- Pace yourself and listen to your body.
- Use caution when taking medications due to chemical sensitivities.
- Avoid environmental irritants, alcohol and junk food.
- Attend support group meetings where others understand how you feel.
- Maintain friendships. Do not let ME/FM isolate you!
- Learn what causes your symptoms to flare up and avoid them as much as possible.
- Don't hesitate to seek the services of a professional. Depression is a normal reaction to chronic illness.
- Try to maintain a positive attitude.