cfs and fibromyalgia - whats the difference?

Discussion in 'Fibromyalgia Main Forum' started by davebhoy, Jan 31, 2006.

  1. davebhoy

    davebhoy New Member

    what is the difference between cfs and fibromyalgia?

    i have cfs, how does it differ from fm?
  2. kylesmom

    kylesmom New Member


    I'm sorry I am too tired to reply to this tonight.
  3. jaltair

    jaltair New Member

    How FMS and CFS are "defined," "diagnosed," and "differentiated"

    For the most part, routine laboratory testing reveals nothing about fibromyalgia or chronic fatigue syndrome. However, upon physical examination, the fibromyalgia patient will be sensitive to pressure in certain areas of the body called tender points. To meet the diagnostic criteria for FMS, patients must have:

    A. Widespread pain in all four quadrants of their body for a minimum of three months

    B. At least 11 of the 18 specified tender points (to qualify for diagnosis) *
    • Occiput: suboccipital muscle insertion
    • Low cervical: anterior aspects of the intertransverse spaces of C5-C7
    • Trapezius: midpoint of the upper border
    • Supraspinatus: above the medial border of the scapular spine
    • Gluteal: upper outer quadrants of buttocks
    • Greater trochanter: posterior to the trochanteric prominence
    • Second rib: second costochondral junctions
    • Lateral epicondyle: 2 cm distal to the epicondyle
    • Knee: medial fat pad proximal to the joint line
    Over 75 other tender points have been found to exist, but are not used for diagnostic purposes.

    {The American College of Rheumatology (ACR) 1990 criteria for the classification of fibromyalgia [Klippel JH, ed. Primer on the Rheumatic Diseases. Atlanta: Arthritis Foundation; 1997:124-127, 457.]}

    While many chronic pain syndromes display symptoms that overlap with fibromyalgia, the 1990 ACR multi-center criteria study (published in the February 1990 issue of Arthritis and Rheumatism) evaluated a total of 558 patients, of which 265 were classified as controls. These control individuals weren't your typical healthy "normals." They were age and sex matched patients with neck pain syndrome, low back pain, local tendinitis, trauma-related pain syndromes, rheumatoid arthritis, lupus, osteoarthritis of the knee or hand, and other painful disorders. These patients all had some symptoms that mimic FMS, but the trained examiners were not foiled--they handpicked the FMS patients out of the "chronically ill" melting pot with an accuracy of 88%. FMS is not a wastebasket diagnosis!

    Although the above criteria focuses on tender point count, a consensus of 35 FMS experts published a report in 1996 saying that a person does not need to have the required 11 tender points to be diagnosed and treated for FMS. This criteria was created for research purposes and many people may still have FMS with less than 11 of the required tender points as long as they have widespread pain and many of the common symptoms associated with FMS. Commonly associated symptoms include:

    • fatigue
    • irritable bowel (e.g., diarrhea, constipation, etc.)
    • sleep disorder (or sleep that is unrefreshing)
    • chronic headaches (tension-type or migraines)
    • jaw pain (including TMJ dysfunction)
    • cognitive or memory impairment
    • post-exertional malaise and muscle pain
    • morning stiffness (waking up stiff and achy)
    • menstrual cramping
    • numbness and tingling sensations
    • dizziness or lightheadedness
    • skin and chemical sensitivities


    Chronic fatigue syndrome is diagnosed using the CDC 1994 guidelines published in the Annuals of Internal Medicine 121(12):953-959. A copy of this article can be downloaded from the CDC (Centers for Disease Control and Prevention) Internet site.

    To meet the criteria, patients must have:

    A. Fatigue

    Severe, unexplained fatigue that is not relieved by rest, which can cause disability and which has an identifiable onset (i.e., not lifelong fatigue). It must be persistent or relapsing fatigue that lasts for at least six or more consecutive months.

    B. Four or more of the following symptoms:

    • impaired memory or concentration problems
    • tender cervical or axillary lymph nodes in neck region (note that they do not have to be swollen but just tender; this can be a problem for people with FMS who have tenderness in these areas as well)
    • sore throat (but may not show signs of infection)
    • muscle pain
    • multi-joint pain (but not arthritis)
    • new onset headaches (tension-type or migraine)
    • unrefreshing sleep (wake up in the morning feeling unrested)
    • post-exertional malaise (fatigue, pain and flu-like symptoms after exercise)

    NOTE: Five of the above eight criteria relate to pain and are often present in FMS as well. For both the fibromyalgia and chronic fatigue syndrome criteria, patients should be evaluated for other problems that could cause pain and fatigue, such as low thyroid function, low iron stores, arthritis and many other medical conditions. If any of these problems are found and corrected, but the individual still meets the FMS criteria, these other disorders (FMS and CFS) are viewed as co-existing and deserving of special medical attention. Unfortunately, the CDC criteria excludes people with other medical problems such as hypothyroidism and lupus, but it is okay to have the tender points of FMS or a mild case of depression/anxiety.

    As a patient, you are deserving of medical care if the CFS symptoms persist and you should pursue therapy options with your doctor. However, when it comes to research studies or prevalence figures determined by the CDC, you will not be included as a CFS patient if you have any other co-existing medical condition (other than FMS and mild depression/anxiety). On the other hand, FMS is viewed as a distinct clinical entity that stands on its own, regardless of whether a person has other medical problems. This may be one reason why the prevalence figures for FMS (2% of the general population) are so much higher than CFS (roughly 0.5% of the general population).

    * Tender points are discreet areas of pain in response to palpation on body surfaces. They are in areas of muscles and muscle insertions and do not involve the joint. Some tender points can be identified in many people, but those suffering from chronic pain disorders tend to have more. Fragmented sleep along with lack of sustained delta wave sleep is theorized to be associated with the phenomenon of tender points.

    (Information has been formulated from several reliable sources. These include the "Fibromyalgia Network," "Medscape," and "US CDC / DHS;" all URL's have been removed to meet guidelines.)

  4. davebhoy

    davebhoy New Member

    according to these definitions there doesnt seem to be much difference at all.

    what does it feel like to have fm?
  5. dononagin

    dononagin New Member

    I know cfs has more immune system issues.. I was diagnosed with cfids first.. Still have alot of trouble with swollen lymph nodes, fevers etc..I didn't develop the trigger points of fibro till later.
    My rhumie after confirming both asked me what my top three complaints were. I told him fatigue, pain and cognitive problems. Thus I was diagnosed cfs/fibro.. If I had said pain first it would have been the opposite.
    He said the line between the two syndromes is very fine and most overlap..