ME and CFS Medical Abnormalities – Pain Issues


Following is a list of articles about abnormalities with pain issues in ME and CFS.

Links to the more than 1,000 peer-reviewed journal articles are listed on the ME and CFS Medical Abnormalities page of this website.


Collin SM, Nijs J, Meeus M, Polli A, Willekens B, Ickmans K. Endogenous Pain Facilitation Rather Than Inhibition Differs Between People with Chronic Fatigue Syndrome, Multiple Sclerosis, and Controls: An Observational Study. Pain Physician. 2017 May;20(4):E489-E497. PMID: 28535557

This study compared experimental pain measurements in patients with CFS or MS and healthy controls. The researchers found differences in the characteristics of pain symptoms reported by patients with CFS and patients with MS, which suggest different underlying mechanisms. Specifically, overactive endogenous pain facilitation was characteristic of pain in patients with CFS but not in patients with MS, suggesting a greater role for central sensitization in CFS.


Terzi R, Altın F. The prevalence of low back pain in hospital staff and its relationship with chronic fatigue syndrome and occupational factors. Agri. 2015;27(3):149-54. PMID: 26356104

The study shows a relationship between low back pain and chronic fatigue syndrome in hospital employees. Shift work and length of time in occupation are risk factors for chronic fatigue syndrome.


Rayhan RU, Ravindran MK, Baraniuk JN. Migraine in gulf war illness and chronic fatigue syndrome: prevalence, potential mechanisms, and evaluation. Front Physiol. 2013 Jul 24;4:181. PMID: 23898301

The high prevalence of migraine in CFS was confirmed and extended to GWI subjects.


Ravindran MK, Zheng Y, Timbol C, Merck SJ, Baraniuk JN. Migraine headaches in Chronic Fatigue Syndrome (CFS): Comparison of two prospective cross-sectional studies. BMC Neurol. 2011 Mar 5;11:30. PMID: 21375763

CFS patients have a higher prevalence of migraine headaches (with and without aura) than healthy controls.


Nijs J, Van de Putte K, Louckx F, Truijen S, De Meirleir K. Exercise performance and chronic pain in chronic fatigue syndrome: the role of pain catastrophizing. Pain Med. 2008 Nov;9(8):1164-72. PMID: 19086101

There is an association between “pain catastrophizing,” bodily pain, exercise performance, and self-reported disability in female patients with CFS who experience widespread pain.


Meeus M, Nijs J, Van de Wauwer N, Toeback L, Truijen S. Diffuse noxious inhibitory control is delayed in chronic fatigue syndrome: an experimental study. Pain. 2008 Oct 15;139(2):439-48. PMID: 18617327

Delayed pain inhibition may play a role in chronic widespread pain in CFS.


Ullrich PM, Afari N, Jacobsen C, Goldberg J, Buchwald D. Cold pressor pain sensitivity in monozygotic twins discordant for chronic fatigue syndrome. Pain Med. 2007 Apr;8(3):216-22. PMID: 17371408

Although cold pain threshold and tolerance levels were slightly lower in twins with CFS than their cotwins without CFS, these differences failed to reach statistical significance. Subjective ratings of pain and fatigue at multiple time points during the experimental protocol among twins with CFS were significantly higher than ratings of pain (P = 0.003) and fatigue (P < 0.001) by their cotwins without CFS.


Meeus M, Nijs J, Meirleir KD. Chronic musculoskeletal pain in patients with the chronic fatigue syndrome: a systematic review. Eur J Pain. 2007 May;11(4):377-86. PMID: 16843021

Chronic pain is important in CFS and needs to be studied more.


Geisser ME, Gracely RH, Giesecke T, Petzke FW, Williams DA, Clauw DJ. The association between experimental and clinical pain measures among persons with fibromyalgia and chronic fatigue syndrome. Eur J Pain. 2007 Feb;11(2):202-7. PMID: 16546424

CFS patients’ responses to painful experimental stimuli were measured.


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