PEM/Post Exertional Malaise CF "Research Brief"

Discussion in 'Fibromyalgia Main Forum' started by victoria, Nov 8, 2010.

  1. victoria

    victoria New Member

    Exercise & Pain Thresholds in Chronic Fatigue Syndrome - Monday November 8, 2010

    Research Brief

    New research supports earlier findings that people with chronic fatigue syndrome (ME/CFS) develop amplified pain after exercise, while healthy people do not. The latest research also showed differences in the exercise/pain response between ME/CFS and chronic low back pain.

    For decades, researchers have been trying to understand a key symptom of chronic fatigue syndrome called post-exertional malaise (PEM). It's an abnormal physical reaction to exercise that causes symptoms to heighten. While most people will get an energy boost from exercise, people with this condition will become intensely fatigued, feel increased flu-like symptoms, and often experience body-wide pain. PEM generally last for at least 24 hours, and can last for several days in some people.

    This study looked at just the pain levels and not the other aspects of PEM. Researchers discovered that when participants with chronic fatigue syndrome exercised within their physical limits, their pain thresholds dropped, causing them to feel pain more easily. (The pain threshold is the point at which sensation, such as pressure or heat, is interpreted by the body as pain. It is not the same as pain tolerance.)

    Researchers concluded that chronic fatigue syndrome involves abnormalities in what's called central pain processing. That means the central nervous system (brain, spinal cord and associated nerves) reacts strangely to signals and essentially "turn up the volume" of pain. This is called hyperalgesia.

    Hyperalgesia is one of the defining characteristics of the related condition fibromyalgia.

    This year alone, at least 5 published studies have explored aspects of PEM. Of those:

    * 3 link it to abnormal pain processing: April 2010 Journal of Internal Medicine, Sept. 2010 Journal of Internal Medicine, and the one detailed here, Oct. 2010 Journal of Rehabilitative Medicine;

    * 1 demonstrates that it's distinctly different from the consequences of a sedentary lifestyle: Feb. 2010 Journal of Women's Health;

    * And 1 points to fluctuating levels of cytokines as a possible cause of this mysterious symptom: (July 2010 Psychophysiology).

    Meanwhile, several researchers are looking for unique biomarkers of PEM in the hopes of finding an objective way to diagnose ME/CFS.

    Does this research match your experience? What is post-exertional malaise like for you? How much exertion does it take to trigger it? Leave your comments below!
  2. ask2266

    ask2266 Member

    Early in my years of ME/CFIDS, after walking a long distance or over exerting myself, I would feel nauseous and have headaches the next day. Mainly, I just had a "hungover" feeling the next day, like I had had 6 liquor drinks or something. Now, about 5 years in, my main symptom the next day is extreme pain all over my body, and I am more deconditioned now, which means I get post exercise symptoms from barely doing anything!!. I can't help but wonder if my chronic fatigue has progressed to be Fibromyalgia now.
  3. mbofov

    mbofov Active Member

    It's interesting how we are all so different. I have no pain issues with CFS. My PEM consists of a complete exhaustion which takes about 24 hours to fully develop after exertion. I'll start to get achy and tired about 6 hours after overdoing it, then sleep, feel worse in the morning and it hits its peak about midday the second day. Overdoing it might be doing one errand too many, or standing in line for 10 minutes at the store. Then it takes a couple of days to recover.

    But no pain. Well, I do get achy muscles, I think it's lactic acid, which dissipates as my energy starts to return.

    Weird how we have all these different symptoms, but basic similarities too - definite problems with energy production.

    Since starting Rich's methylation protocol and doing lots of detoxing besides that and adding d-ribose, I am recovering quicker now from PEM. But still have a pretty low thresshold of activity that I can tolerate.

    I wish the research were done to explain why some people have pain issues, others cognitive (I don't hvae cognitive issues either), and then energy production malfunction and impaired immune functioning which I do have also.

    There's so much to learn.