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Adrienne Dellwo

Illness Clusters: The Reason Fibromyalgia & Chronic Fatigue Syndrome "Bring Friends"

By December 31, 2011

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Most people with fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS) also have a few other illnesses, and both research and observation have long shown that specific illnesses tend to accompany FMS and ME/CFS.

In a review of FMS literature, noted researcher Dr. Muhammed Yunus presents evidence for the cluster of illnesses we generally see all having a key feature in common: central sensitization (CS). As a group, they're called central sensitivity syndromes (CSS), although some of the conditions are classified as diseases.

The many illnesses Yunus identifies as CSS include:

Yunus says it's important for doctors to be aware of these overlaps so they can accurately diagnose and manage FMS when it accompanies other conditions.

What is Central Sensitization?

Usually when we hear about sensitization or sensitivity, it has to do with an allergy. In an allergy, the body becomes sensitive to a particular substance and thereafter reacts inappropriately to it.

The central part of CS refers to the central nervous system, which is made up of the brain and spinal column. The central nervous system, in these conditions, because sensitized to "noxious stimuli," which is basically any input that's unpleasant - pain, bright light, certain noises, etc. As with an allergy, the body begins to react inappropriately to that input.

As a result, what should be mild discomfort becomes pain, an obnoxious noise may trigger pain or anxiety, and light pressure from a waistband may cause a burning feeling on the skin and a deep ache in the muscles and connective tissues.

Yunus says evidence supports the theory that CS is a causal factor in these illnesses and the reason that they so often occur together. (Causal factor means that it is one of many causes that come together and not the sole cause.) Having one CSS predisposes you to the others.

My Experience

I can see CS at work in my life from an early age. I have myofascial pain syndrome, which I believe started with an accident at age 10 that jarred my entire spine and caused lasting muscle damage and, I'd eventually learn, multiple trigger points. I've had chronic pain since then.

In high school, I started having mild TMJ symptoms. In college, my job waiting tables lead to carpal tunnel disorder. I had severe gestational diabetes with both pregnancies.

Close relatives on my mother's side have/had diabetes, inflammatory bowel disease, interstitial cystitis, osteoarthritis and multiple chemical sensitivity. This is a good example of a genetic predisposition toward CS, which Yunus discusses.

Which CS conditions do you have? Which others are present in your family? Leave your comments below!

Learn more or join the conversation!


Photo © A.D.A.M.

January 2, 2012 at 12:48 am
(1) Julie says:

I have Fibromyalgia, Endometriosis, Irritable Bowel Disease, Restless Leg Syndrome, Osteoarthritis, Post Traumatic Stress Disorder, Carpal Tunnel Disorder and Inflammatory Bowel Disease. I’ve often wondered why nobody made the connection between the illnesses. I knew there had to be a connection and I only wish the Medical Community would look more closely at that connection.

January 2, 2012 at 12:57 am
(2) Kristiana Ng says:

I was diagnosed Fibromyalgia four years ago and I have had the symdrome as below:

• Chronic fatigue syndrome
• Irritable bowel syndrome
• Restless legs syndrome
•• Systemic lupus disease
• Carpal tunnel disorder
• Myofascial pain syndrome

All of the above things is affecting my daily life like plainy piano and harp. Because of pain, I cannot practise more the a hour every day….so I cannot take the performing level exam…..

January 2, 2012 at 1:21 am
(3) anne says:

I have rheumatoid arthritis and hypothyroidism

January 2, 2012 at 1:33 am
(4) Cris says:

i was diagnosed with cfs & fibro and also the following
•Chronic fatigue syndrome
•Irritable bowel syndrome
•TMD/TMJ (temporomadibular disorder)
•Restless legs syndrome
•Inflammatory bowel disease
•Carpal tunnel disorder
•Myofascial pain syndrome
•Multiple chemical sensitivity
•Post-traumatic stress disorder
•Interstitial cystitis
i suspect that i have Ankylosing spondylitis, but no diagnosis. i have been ill for many many years. i am 49 and started the diagnostic process when i was 31. i also have had espstein barr. gall bladder disease that almost poisoned me to death when i was 42. i have chronic sinus infection, ashma and severe allergies. also have frequent bladder, rectal and vaginal yeast infections but no diabetes which is what yeast is associated with. i suffer from almost every form of headaches. i can not remember a day in my life that i have been headache free.
i hope for a medical breakthrough every day.

January 2, 2012 at 5:58 am
(5) Esta says:

I was diagnosed with fibromyalgia+cfs nearly 5years ago..since then, I have started getting lots of other symptoms including restless leg syndrome, extreme sensitivity to light+noise+skin pain, +food allergies..plus I have severe Tmj-which I have had surgery for,also steroid injections+Botox!
I’m not happy with the way I have been treated by my Gp- given anti depressants,co codamol+basically told ‘get on with it,u’ll be ok’ +like I’m wasting their time. I know myself that alot of symptoms I get are fm+cfs, but I would love it if someone would listen to me+,if possible,help me!:)

January 2, 2012 at 9:19 am
(6) Angela says:

Hla-b27 is a genetic marker which you can be tested for to see if you have AS. I have it, simple blood test. I also have ibs, which I now relate to being lactose intolerant! I have osteoarthritis, restless leg, 3 herniated discs, reverse curve of the neck. Sensitivity to sound, light and touch. Need to have weighted bedding. I have also been diagnosed with Gilbert’s Syndrome. Also I have some other gene where my immune system is hyper-sensitive and fights itself and causes inflammation. I have severe chemical sensitivity, and can’t be around cigarette smoke at all without getting sick. Also, vertigo. Ok I am stopping, did I mention it is time to get out of bed! Also vitamin d deficient, but found taking more d supplement caused me to get kidney stones!

January 2, 2012 at 9:34 am
(7) Pat says:

As I read these comments I see my own history with fatigue, random pain and stiffness, IBS, headache, AS etc. My health issues were triggered by an exposure to a pesticide. I am wondering how many of you can define a chemical injury with your onset of symptoms.

January 2, 2012 at 10:47 am
(8) Lisa says:

diagnosed with FM in 1993, Interstitial cystitis, hypothyroid, hypoadrenalism, endometriosis, psoriatic arthritis, TMJ, restless leg, I also believe I have AS but not diagnosed yet, plantar facisitis, OSA for which I had extensize recontructive surgery, I have rejected titanium, multiple issues with bursitis and tendonitis, yeast overload,pernicious anemia, and just waiting for the next axe to fall. I still work full time at my own business, but am no where near as productive as I was even a couple of years ago.

January 2, 2012 at 11:36 am
(9) Candy says:

Fm, carpal tunnel, high RA factor, irritable bowel, gestational diabetes, diseased gall bladder removed.

January 2, 2012 at 3:39 pm
(10) Myrna says:

I live in South Dakota and have trouble getting any diagnosis other than general Fibromyalgia from a nuerologist, ruematoidologist and dermatologist.. In 2005 I went to the Mayo Clinic in Minnisota with the same outcome. I know I suffer from restless leg, bladder problems, chemical sensitivity, sound sensitivity, light sensitivity, brain fog, freguent headaches and migraines, allergies, skin pain, rashes, and irritable bowel syndrome just to name a few. I was uninsured from 2006 until this past April. The insurance I now carry is supplied from a job change by my husband. Is my lack of insurance and money the reason or is it the area I live? Help, I feel hopeless!

January 2, 2012 at 5:26 pm
(11) Yvonne Herrington says:

First I experienced leg pain when I was 12 years old, my parents said it was growing pains, 39 years later I still have those pains when I lay down at night.

January 2, 2012 at 7:53 pm
(12) Heather Guhl says:

From Birth: sensitive to emotions and injuries, plus lived in a household with lots of hatred and meanness
Nothing seemed to happen until age 20, extreme relationship stress…than my genetic defects (I believe) broke….
First IBS
Second Immune system problem leaving me vulnerable to respiratory and GI viruses that I got all the time I was working at a RN in Cardiac ICU
Than an accident:
RSD – I controlled a bit with hyperbaric oxygen. However, my nervous system was already set up….
Also thoracic outlet syndrome
myofascial pain
body structure damaged plus, structure is abnormal…
Neck pain and problems – later had surgery for herniation
Back pain – again another disc had to be replaced yrs later
inflammatory condition still not understood
autoimmune thyroid
Multiple allergies – very reactive too
post traumatic stress disorder
literal brain damage- temporal lobe memory loss probably from:steroids letting viruses take over,
that was the beginning of true chronic fatigue syndrome
Flying and rain/snow are very bad for my health
very severe pain reactions that can’t be anything but sympathetically mediated with central sensitization issues

Family hx: back problems, depression, autoimmune thyroid, some wierd blindness genetic stuff, diabetes-like everyone, cancer….no doubt there’s more

January 3, 2012 at 10:08 am
(13) Julie (JASZ) says:

Doctors don’t know what they are doing! I have grown so incensed I wrote “The Diagnoses”, for orchestra. As they say, art comes from great suffering. You can hear it on the above link.

January 3, 2012 at 11:08 am
(14) lloyd says:

The clustering of problems experienced by central sensitization is indeed interesting. However, one should recognize that fibromyalgia itself has many symptoms. Many of those that Myrna lists–light and sound sensitivity, brain fog, headaches, brain fog, irritable bowel, even rashes–are common fibromyalgia symptoms.

January 3, 2012 at 3:24 pm
(15) Lee Ann says:

I started with Fibro, which then went away for about four years. Ah relief, I thought it was gone. No such luck. I was diagnosed with narcolepsy in 2005. Narcolepsy that caused me to wake up 16 times an hour and get no refreshing sleep, so I was trying to sleep 16-20 hours a day. As I got that under control with medication, my fibro started up again, so I have narcolepsy, fibromyalgia, IBS, venous insuffiency in my legs, neuropathy (can’t feel my feet, but have no diabetes), arthritis in hands, naturally, depression. On a narcolepsy site I visit, about 50% of us have fibro. About 30% of us have IBS. Talking to my rheumatologist, she said that a lot of fibro problems are caused as a sleep disorder, wake someone up enough times and they will develop fibro. I originally went to her to be checked for lupus, and she confirmed the arthritis and fibromyalgia. I had to apply for disability last month because I was struggling so hard to continue my job, and they said I was not doing my job well enough. So I was terminated. Today is a bad day for me. Hope 2012 is better for all of us.

January 4, 2012 at 2:57 pm
(16) Tiffany says:

I have fibromyalgia, hypopituitarism, prolactinoma, ringing in my ears, depression, anxiety, chronic fatigue, carpal tunnel, eczema…..

January 4, 2012 at 4:24 pm
(17) AndyJ says:

I really emphasize with you all.

For me it’s:
Restless Leg Syndrome (very mild)

I’m particularly intrigued with Pat’s comment about exposure to pesticide.

As a child, I lived in a home which had been painted (internally) with paint that included added insecticide.

Awful to think that something like that could have life-long effects…

January 6, 2012 at 6:54 pm
(18) Cindy says:

Isn’t it interesting to see the recurring themes of CS. As a child I always had bad colds. As a result of military sexual trama at 18, I was diagnosed with PTSD over thirty years after the fact. I believe did much to contribute to fibro and probably CFS. Have dealt with pain all my life that quadrupled less than a year after a total hysterectomy. The VA (veterans administration) couldn’t understand why I had the extreme pain problems I was having after being diagnosed with degenerative disc disease of the back, neck, and shoulder. It took two more years until I received a diagnosis of fibro. Also was diagnosed with CFS (no exact testing for it however) by several doctors in 99′ and 00′. Have always been what can be termed a HSP, highly sensitive person, with a tendency towards depression and anxiety. So there you have my story.

January 7, 2012 at 10:40 am
(19) Sandi says:

Hi, I also have a lot of different ailments. As a young child I had a constant runny nose, and disliked milk. On my mother’s side there is a wheat intolerance. I seemed to have a constant cold which I now realise was allergic rhinitis. Childhood was pretty awful. At 14 I had pleurisy. In my late 20′s I was tested for allergies. I was not significantly allergic to anything, but ever so slightly allergic to everything! My theory is that I had allergic rhinitis from the day I was born, or perhaps the home situation brought it on. Nothing was ever done to deal with rhinitis, probably because I was not allergic to flowers or grass so defied the name Hay Fever. Having this ‘foundational’ attack on my immune system and slight intolerances all the time, has I feel, made my system vulnerable to anything that comes along.

I have most of the things mentioned before, but also Menieres Syndrom, but before fibro was thought of, Chronic Kidney Disease, Sciatica, Gout, High BP etc. etc.. I don’t like visiting doctors as they usually say there is nothing they can do for me.
I use meditation, and various subliminal tapes. I have used all manner of complementary therapies. The most efficacious has been Bowen Therapy, but I can’t afford it at present. Someone has kindly lent me a magnetic sleep system. I am going to buy magnetic soles – they are a little more gentle than the sleep system. I have become interested in this since I learnt that an agent in London was in a wheel chair because of fibro and after using magnets she is now running her own business and her fibro symptoms are very much under control.
My biggest frustration is not being able to concentrate for very long, or finding something simple like potting a couple of plants takes me 40 mins with a 2 day rest period needed afterwards! But i really do miss my reading, being able to read for no more than 15 mins drives me mad!
Good luck to everyone and if the magnetic soles help I will let you know..

January 9, 2012 at 1:12 am
(20) Richard Andersen says:

Hi everyone

Have you heard about Glycobiology?
Maybe it could help some of you with your problems.
check out my blog about it:

February 12, 2012 at 11:50 am
(21) Treatment Diaries says:

WOW! This is exactly why so many are using treatmentdiaries.com as a way to connect across all illness. This makes sense as to why so many of our users are registered for multiple conditions – much like those in the comments above. We hope you will stop in to the site and see how others are coping and healing through shared diaries in encourgagement. We are here to help!

March 25, 2012 at 10:07 am
(22) Shelley says:

I have RSD/CRPS, fibromyalgia & now RLS. I find it difficult to believe that there is no link between these 3 disfunctional nerve based conditions.

I was part of a study at Stanford adressing RSD in he upper extremeties. The outcome revealed that people with chronic
pain LOSE up to 6% of their brain! The remaining brain learns
to take over the functions from lost part, much like stroke
victims. I’m thinking that might be the cause of the loss of
cognitive thinking associated with chronic pain.

May 11, 2012 at 9:57 pm
(23) Newly Diagnosed with CSS says:

Diagnosed recently with CSS after evaluation at Mayo.

Symptoms that led to this diagnosis:

* Facial pain/swelling
* Blurred vision
* Nausea
* Fatigue
* Brain fog

History of severe nerve damage due to surgery (Popliteal By-pass) performed due to Femoral artery being destroyed by a heart cath. Colon resection ( Diverticulitis w/ fistula). Multiple diagnosis of this being a silent migraine prior to CSS diagnosis.

July 7, 2012 at 11:26 pm
(24) keitha says:

I have ankolosing spondylisis, gluten intollerance, fibro, interstitial cystitis,

August 8, 2012 at 7:27 am
(25) john says:

i had a work injury here in new zealand almost a decade ago-the diagnosis at the time was that i had prolapsed my L4 disc and damaged all the nerves in the immediate area. The public health provider however fobbed it off as a simple back sprain despite numerous proffessionals making reccommedations to get an MRI done asap to confirm. wind the clock forward 8 or so yrs now, i have sufferred wicked sciatica in either or both legs almost daily to the point that you have to learn to distract yourself or ignore it else you cant function, i have also sufferred numbness in the lower body including the “old fella”-trust me when i tell you pins and needles there hurts like you wouldnt believe! for years i have had to lie on the floor next to the toilet waiting to be able to use my legs again!, i saw my GP numerous times over these years but nobody seemed that concerned-then one day i suddenly find my legs getting weaker and weaker for no reason at all, to the point that i ended up in hospital. i also had this unbelievable “pain wave” that kept racing through my body and lefi my lower half alike to having a covulsion fit. after 10 months,2 mrI scans, and numerous specialists appointments,i find i have this thing called central sensitisation, and yes its a direct result of the injury yrs ago. since i have accepted it so to speak, and learned more about it, i have also began to understand it, and to a degree learn what can trigger one of these pain waves that leave me convulsing in agony.I am not quite 40 yrs old,and i own a mobility scooter, and i’m being told i shouldnt be working….all because of the public system being to thrifty and refusing an MRI yrs ago. dont worry its going to court, but all the pain meds etc…i have 25 pills a day for pain-what is the payback going to be for that i am wondering??

August 19, 2012 at 11:29 am
(26) David says:

My fibro started after I had pancreatitis due to a diseased gall bladder. I then found I had a pituitary tumour, pineal cyst and hypogonadism. I suspect there is a link between the tumour on my pituitary gland and fibromyalgia. I suspect the tumour I suspect is messing with the pituitary glands function and causing things to be put into my system that should not be their or not to put things in my system that should be there. Looking at articles in the Fibromyalgia network journal I can see how this could be true. I also have a large hiatus hernia, chronic migraines, chronic fatigue, indigestion problems, irritable bowel problems, chronis agonising muscle pain all over, depression and anxiety. insomnia. I cant find a doctor who will take my illness seriously. I live in a small remote country town and only one doctor will see me and even he doesnt seem to have a clue how to treat me. Quite frankly each nigh I go to sleep hoping never to wake up as I’ve had enough.

October 13, 2012 at 3:02 pm
(27) Tanya Proctor says:

I had a major RTA in 2008 at that time high functioning in a well paid demanding but I coped easily full time and some! work play dance all night etc ! I am now 41 since the day of the accident I have been unable to work at all,I barely function in life to be honest getting out of bed is a challenge most days..I had a ‘mild’ head injury syndrome which after 2 years improved but I still have memory/concentration issues and processing difficulties.I had a seatbelt injury to my right shoulder and several muscle nerve injuries all right sided.I have had problems with my shoulder since day one but now have intense burning and muscle ache which has spread into my whole upper torso /worse on the right.low back pain/ankle pain/foot pain which makes it painful to walk..sometimes feel like I have false boots on with numbness after rest.Mornings are hell need an hour or two after meds to get up! excercise has me on my bed for days after .I have a lump in my throat which is there all the time now feels like its blocked ..blood test revealed low functioning thyroid.. I suffer severe cramping of my muscle all right side neck to foot ,calf muscles are rocks.I have put weight on due to meds and immobilisation.Last consultant says it is Central Sensitization disorder ? can it be this and would the accident have caused it.
I feel like a hypercondriact now having previously never seen my gp

October 15, 2012 at 10:20 pm
(28) Nina says:

I have osteoarthritis, restless legs, carpal tunnel, sleep apnea and COPD as well as just being diagnosed with Fibro this summer. I have had carpal tunnel since my pregnancy 17 yrs ago, sleep issues as long as I can remember, restless legs for many years, and osteoarthritis after my first car accident in 1975 with damage to my knees and spine.

March 5, 2013 at 4:51 pm
(29) Nigel says:

This is an interesting article and imo there may be other reasons for the connection of clusters and that may well be bacterial infections that can diversify their total symptom package to each patient by the history of the patient. The use of diet throughout life to ‘protect’ against infection by the use of Herbs which can be anti microbial and anti bacterial during ones life span is a classic example of how in periods of life the bacteria can infect and adapt to to the immune system and also modify the immune system.
CPn research is showing the stealth of bacteria and the outcomes by the variety of diseases implicated by finding high levels of CPn bacterial load, see http://cpnhelp.org/diseases_and_symptoms_ass

April 28, 2013 at 12:54 pm
(30) ez says:

I have scleroderma, fibromyalgia, sjogrens syndrome. Migraines, chronic fatigue, pain, joint inflammation, depression, anxiety, dislocating joints. Insomnia. Insanely sensitive to smells, noise, sometimes also light. Blah blah blah.

June 26, 2013 at 12:49 pm
(31) adult chatroulette alternative says:

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September 4, 2013 at 9:21 am
(32) Elaine says:

Oh! Can I empathise!
Family hx: asthma, heart problems, diabetes, ovarian cancer, uterine cancer, eczema, chronic respiratory ailments, depression, Bi Polar Disorder, talipes, menstrual problems, congenital hip displacement, arthritis, osteoporosis. Multiple Sclerosis, Tuberculosis, Polio, allergies, food sensitivities (that’s all the stuff I can remember – probably there’s more).
Personal hx:
Born “Blue baby”, hypoplasia left frontal sinus, talipes. Serious respiratory infection aged 6 months. Nosebleeds = young child.
Respiratory infections throughout teens. Also menstrual problems & migraine.
Serious reaction to insect bites began in teens.
I now have Asthma (from 1990), Chronic Sinusitis, Endometriosis (severe menstrual problems worsened 2002, suspected 2008, confirmed 2011), Post Viral Syndrome/M.E./Fibromyalgia (from 2006), Migraines, Reynauds Syndrome, Restless Legs, Food Intolerances (suspected IBS), low Haemoglobin & Ferritin levels, Cystitis infections, Candida infections, water retention, Adenomyosis (suspected), postural hypotension, bowel & bladder problems.
I have received very poor treatment from medical professionals, misdiagnosis & failure to treat known conditions. Fobbed off lots of times, made to feel like a malingerer. G.P.s tried to suggest my problems are all “stress” or indicative of mental instability! My treatment is now the subject of a medical negligence investigation.
I had numerous surgeries, live a very pressured life (carer for mentally ill mother, high pressure job, postgraduate study, several recent bereavements). My childhood was traumatic, to say the least – fostered on several occasions due to mother’s mental illness.
I think you have a very good hypothesis, but even this is a little too simplistic. We need also to consider the effects of stress and trauma; damage to the immune system; neurological causes (e.g brain over-sensitisation to pain); nervous system causes; viral infection causes. A combination of all?

December 31, 2013 at 6:38 pm
(33) xt genix and zx90 says:

Oh my goodness! Amazing article dude! Thank you so much,
However I am having issues with your RSS. I don’t know
why I cannot join it. Is there anybody else having similar RSS problems?
Anyone that knows the answer will you kindly respond?

April 29, 2014 at 7:42 am
(34) Newly Wise says:

Hi all, I’m 33, I have been having problems since I was I child with what I now know was interstitial cystitis as my daughter has it as well. I was also diagnosed with celiac disease when I was 23 which was also present as a child. Diagnosed with endromentriosis this year and Now im waiting for my results for Ankylosing spondylitis gene test and appointment with specialist. Any way I would just like to say that I recommend getting tested for celiac disease and going gluten free I hated going gluten free but it had helped some of my symptoms I was sick, depressed, had mental issues for years until I went gluten free now I’m a different person is wonderful. I have read research that say gluten can enter you blood stream and make its way to your brain where your immune system still attacks it and damages your brain. And the fact that you are malnutrition because your body attacks you r vili in your stomach that absorb all you nutrients. Also cutting out tomatoes for me helped with my interstitial cystitis. Cutting out food and introducing them one at a time to see what you allergic to helps a lot. A lot of the disease above are autoimmune. Check out this site as it’s worth trying to get you body in balance and reversing our body’s attacking them selfs.


I would love for you all to start feeling better as I am. They are definitely all related and more research needs to be done.

This is my first ever post any where so I hope I made some sense :)

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