While it's true that the symptoms are remarkably similar, these conditions aren't the same. The top researchers of both syndromes point to numerous differences that should not be ignored.
Yes, these 2 conditions have a lot in common, including:
- Major symptoms are pain, fatigue, unrefreshing sleep & brain fog
- Many of the same medications are used to treat them
- Central sensitization
- Abnormal response to exercise
However, those are largely surface similarities. When we talk about pain, most of us (including health-care workers) don't have a good vocabulary for different types of pain. When you look deeper, you discover that FMS is linked to pain states such as hyperalgesia (pain amplification) and allodynia (pain from a typically non-painful source). ME/CFS, meanwhile, is associated with muscle aches like what you get with the flu. Also, not everyone with ME/CFS has pain.
We also have woefully poor language for describing fatigue, but here again, research shows that people with ME/CFS have unique fatigue states. The same has not been found about FMS, and not everyone with FMS has fatigue.
The types of unrefreshing sleep are vastly different, as well. People with ME/CFS may sleep most of the time, yet never feel rested. So far, researchers have been unable to identify any actual sleep disorders in ME/CFS, but they have found abnormal sleep patters. FMS, on the other hand, is generally characterized by one or more recognized sleep disorders as well as abnormal sleep rhythms. In many, the sleep disorders pre-date FMS. Generally, those with FMS get very little sleep.
When it comes to exercise, which causes symptom flares or "crashes" in both conditions, studies link the reaction to different physiological processes, including low growth hormone in FMS and abnormal heart rhythms and lactic acid processing in ME/CFS.
The presence of central sensitization puts these conditions in the same overall category, but it's not unique to these illnesses.
Both conditions have scientifically discovered abnormalities that aren't found in the other, including:
- Greater immune dysfunction in ME/CFS
- Abnormal nerve response in FMS
- Stress-system (HPA axis) abnormalities predominantly from the adrenal glands in ME/CFS and the hypothalamus in FMS
- Elevated pro-inflammatory cytokines in ME/CFS, and sometimes elevated anti-inflammatory cytokines in FMS
In addition, leading researches of both FMS and ME/CFS say that subgrouping is the future. Many of them believe that FMS and ME/CFS are themselves umbrella terms for similar but distinct conditions.
What FMS or ME/CFS myths have you come across? Leave a comment to let me know about it!
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