Overlapping Conditions
Overlapping conditions are ailments that frequently occur together. Fibromyalgia syndrome (FMS) and chronic fatigue syndrome (CFS or ME/CFS) are generally considered overlapping conditions. FMS and ME/CFS also have a host of other overlapping conditions associated with them. These include other pain disorders and sleep-related issues as well as major depression, nervous system disorders and abdominal and menstrual problems. (To get a better understanding of how such different disorders can be tied together, take a look at the article on dysautonomia by heart-disease guide Richard N. Fogoros, M.D.)
Pain Conditions
Myofascial pain syndrome (MPS) is frequently confused with fibromyalgia, but they are different conditions. In MPS, muscles and connective tissues (which make up the fascia) develop what are called trigger points. These are not the same as the tender points associated with FMS. A trigger point is often a small, hard knot about the size of a pencil eraser. You may be able to feel this knot under the skin. Sometimes the knot itself is painful, especially when you press on it, but it often causes pain in another area. That is called referred pain.
Trigger points typically form as a result of trauma to the tissue. Researchers don't know why damage that heals normally in most people causes trigger points to form in people with MPS. It's tricky to diagnose MPS, especially when you have referred pain, because you've never had an injury to the painful area. People who have pain from FMS or ME/CFS may not realize myofascial pain is something different.
Important note:The distinction between FMS/ME/CFS and MPS is an important one, because many cases of MPS are curable. Treatments include acupuncture, trigger point injection, and a special form of physical therapy called spray-and-stretch. Before treatment, however, you need to sort out your symptoms and figure out where your trigger points are.
Chronic headache
Some researchers believe that people with chronic headaches, such as migraines, and those with FMS may share common defects in systems that regulate specific chemical messengers in the brain, such as serotonin and epinephrine (adrenaline). Doctors have found low levels of magnesium in both groups as well, and when chronic migraine sufferers don't respond to usual therapies it sometimes leads to a diagnosis of FMS. Chronic headache frequently occurs with ME/CFS as well.
Migraine symptoms include heightened sensitivity to light and sound, nausea, vision problems such as auras or tunnel vision, difficulty speaking, and intense pain that's stronger on one side of the head.
Multiple chemical sensitivity
Multiple chemical sensitivity (MCS) causes similar symptoms to ME/CFS and FMS, but with the trigger being exposure to certain chemicals, such as those found in perfumes, adhesives and cleaning products. Because everyone is exposed to a huge variety of chemicals every day, it can be extremely difficult to identify which ones are causing the problem, or even that the problem is in fact MCS.
Gulf War syndrome
Symptoms of Gulf War syndrome (GWS) are strikingly similar to those of FMS and ME/CFS, including fatigue, musculoskeletal pain and cognitive problems. Also similar is that symptoms and their severities vary widely from person to person. A study released in 2008 showed a connection between a rare genetic abnormality and GWS, and researchers now believe that this abnormality combined with exposure to certain chemicals and/or vaccines lead to GWS. The same genetic abnormality is linked to the neurological condition amyotrophic lateral sclerosis (ALS or Lou Gehrig's Disease.)
Sleep Disturbances
Restless leg syndrome
Restless leg syndrome (RLS) is a movement disorder that causes discomfort, unease and weariness that gets worse when you rest and feels better when you move. It can keep you awake because it's hard to get comfortable, and the movements can wake you up as well. RLS is not well understood.
Periodic limb movement disorder
Periodic limb movement disorder (PLMD) is similar to RLS. People with PLMD involuntarily contract their leg muscles about every 30 seconds while they're asleep. Even if this doesn't wake you up completely, it can disrupt sleep -- both for you and for your sleeping partner.
Major Depression
As many as 70% of people with FMS or ME/CFS also have had bouts with depression at some point in their lives, and up to a third are currently suffering from a severe form called major depression. Researchers don't believe depression actually causes fibromyalgia but say it may increase your susceptibility.
Major depression is much more serious than the normal periods of sadness and despondency that can go along with chronic pain and fatigue. Symptoms of major depression include:
- Daily depressed mood
- Loss of interest in usually pleasurable activities and interests
- Significant weight changes
- Insomnia or excessive sleeping
- Constant low energy
- Feelings of worthless or inappropriate guilt
- Inability to make decisions or concentrate
- Thoughts of suicide
It's crucial for people with signs of major depression to get professional help.
Possible Nervous System Disorders
Other symptoms that sometimes show up alongside FMS include:
- Chest pain
- Heart palpitations (irregular or forceful heart beat)
- Possible association with mitral valve prolapse (heart valves not closing properly)
- Sudden drop in blood pressure
Excretory & Menstrual Problems
Irritable bowel syndrome
People with irritable bowel syndrome (IBS) have alternating bouts of constipation and diarrhea, and have frequent abdominal pain. Other symptoms include nausea and vomiting, gas, bloating and abdominal distention. The intestine itself is fine, but in some people symptoms may be caused by a lower tolerance for stretching and movement of the intestine, or possibly a problem with muscle movement.
A lot of people with IBS don't seek medical care, but it's important to do so. IBS can lead to malnutrition or dehydration (brought about by avoiding food) and depression. Treatment of IBS can include medications and dietary changes.
