Article

Chronic musculoskeletal pain in chronic fatigue syndrome: Recent developments and therapeutic implications

Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Bruxelles, Brussels Capital, Belgium
Manual Therapy (Impact Factor: 1.76). 09/2006; 11(3):187-91. DOI: 10.1016/j.math.2006.03.008
Source: PubMed

ABSTRACT Patients with chronic fatigue syndrome (CFS) experience chronic musculoskeletal pain which is even more debilitating than fatigue. Scientific research data gathered around the world enables clinicians to understand, at least in part, chronic musculoskeletal pain in CFS patients. Generalized joint hypermobility and benign joint hypermobility syndrome appear to be highly prevalent among CFS sufferers, but they do not seem to be of any clinical importance. On the other hand, pain catastrophizing accounts for a substantial portion of musculoskeletal pain and is a predictor of exercise performance in CFS patients. The evidence concerning pain catastrophizing is supportive of the indirect evidence of a dysfunctional pain processing system in CFS patients with musculoskeletal pain. CFS sufferers respond to incremental exercise with a lengthened and accentuated oxidative stress response, explaining muscle pain, postexertional malaise, and the decrease in pain threshold following graded exercise in CFS patients. Applying the scientific evidence to the manual physiotherapy profession, pacing self-management techniques and pain neurophysiology education are indicated for the treatment of musculoskeletal pain in CFS patients. Studies examining the effectiveness of these strategies for CFS patients are warranted.

Full-text

Available from: Mira Meeus, May 28, 2015
0 Followers
 · 
128 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Chronic fatigue syndrome (CFS) is a poorly understood condition that presents as long-term physical and mental fatigue with associated symptoms of pain and sensitivity across a broad range of systems in the body. The poor understanding of the disorder comes from the varying clinical diagnostic definitions as well as the broad array of body systems from which its symptoms present. Studies on metabolism and CFS suggest irregularities in energy metabolism, amino acid metabolism, nucleotide metabolism, nitrogen metabolism, hormone metabolism, and oxidative stress metabolism. The overwhelming body of evidence suggests an oxidative environment with the minimal utilization of mitochondria for efficient energy production. This is coupled with a reduced excretion of amino acids and nitrogen in general. Metabolomics is a developing field that studies metabolism within a living system under varying conditions of stimuli. Through its development, there has been the optimisation of techniques to do large-scale hypothesis-generating untargeted studies as well as hypothesis-testing targeted studies. These techniques are introduced and show an important future direction for research into complex illnesses such as CFS.
    Advances in clinical chemistry 01/2014; 66:121-72. · 4.30 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: 1. PSA in Screening for Prostate Cancer: More Good than Harm or More Harm than Good? 2. Ovarian Cancer Biomarkers: Current State and Future Implications from High-Throughput Technologies 3. Procollagen Assays in Cancer 4. Metabolomics in Dyslipidemia 5. Metabolism in Chronic Fatigue Syndrome 6. Cellular Regulation of Glucose Uptake by Glucose Transporter GLUT4 7. Identifying and Reducing Potentially Wrong Immunoassay Results Even When Plausible and “Not-Unreasonable”
    Advances in clinical chemistry 04/2014; 66:1-294. · 4.30 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Therapeutic neuroscience education (TNE) aims to alter a patient's thoughts and beliefs about pain and has shown efficacy in treating chronic pain. To date, TNE sessions mainly consist of one-on-one verbal communication. This approach limits availability of TNE to pain patients in remote areas. A 32-year-old patient with chronic low back pain (CLBP) who underwent surgery for thoracic outlet syndrome (TOS) attended a single clinic one-on-one TNE session followed by TNE via electronic mail (e-mail), pacing and graded exposure over a 4-month period. A physical examination, Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), the Disabilities of Arm, Shoulder and Hand (DASH), and Fear-Avoidance Beliefs Questionnaire (FABQ) were assessed during her initial physical therapy visit as well as 1 and 4 months later. Pre-TNE, the patient reported: NPRS (arm) = 7/10; NPRS (leg) = 4/10; ODI = 10.0%; DASH = 36.7%; FABQ-W = 24; and FABQ-PA = 17. After 5 e-mail sessions all outcome measures improved, most noticeably NRS (arm) = 2/10; NRS (leg) = 0/10; DASH = 16.7%; FABQ-W = 8; and FABQ-PA = 7. TNE can potentially be delivered to suffering pain patients in remote areas or to individuals who have time and financial constraints, and likely at a significant reduced cost via e-mail.
    Physiotherapy Theory and Practice 04/2014; DOI:10.3109/09593985.2014.912255