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Exercise Pain in Chronic Fatigue Syndrome/Fibromyalgia vs. Rheumatoid Arthritis

Research Brief

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Updated June 13, 2014

Exercise Pain in Chronic Fatigue Syndrome/Fibromyalgia vs. Rheumatoid Arthritis
New research demonstrates the negative pain-related impact of exercise on some people with chronic fatigue syndrome (ME/CFS) and comorbid fibromyalgia (FMS) and suggests that drug treatments may help lessen the effects in some cases.

Please note: this study looked at the pain response to exercise, not the full breadth of exercise-induced symptoms that are common in ME/CFS. Myriad studies have examined post-exertional malaise, which is the symptom flare following activity, and have demonstrated multiple abnormal physiological reactions to exercise. The intent of this study was to compare two chronic pain populations to see how they differ.

Researchers had a group of women with ME/CFS/FMS, a group of women with rheumatoid arthritis (RA,) and a group of healthy women exercise on a bicycle and looked at several measures of pain before and after the sessions. Half of them received a placebo while the others were given the pain drug paracetamol.

Exertion levels were below maximums and exercise sessions were a full week apart.

Their analysis showed:

  • The RA group had reductions in pain after exercise, both with the drug and with the placebo;
  • In the ME/CFS/FMS placebo group, some measures showed worsening pain while other measures were in conclusive but seemed to indicate worsening;
  • In the ME/CFS/FMS paracetamol group, some people had a decrease in pain measurements, but the decrease was not significant.

By comparing two chronic pain populations, researchers are able to show that the different response between the ME/CFS/FMS group and healthy controls are not merely due to the presence of chronic pain.

This was a fairly small study, but it and any further research it spawns could add to our understanding of this hallmark symptom of ME/CFS. (My assumption is that they included people who also had FMS because not all cases of ME/CFS involve significant pain.)

Also, it shows that medication may be able to help alleviate exercise-induced pain, at least in some. (However, paracetamol results in this study were not terribly impressive.)

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