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A large numnber of men with pelvic pain report symptoms of CFS and Fibromyalgia. Is there a connection?

Many Patients have reported a CFS-like illness at or near the onset of their CP/CPPS. Recent studies have shown that CFS is indeed linked to chronic prostatitis.

What Is Chronic Fatigue Syndrome?

Chronic Fatigue Syndrome (CFS), also sometimes called myalgic encephalomyelitis (ME) in Europe, does not appear to be new. In the 19th century the term neurasthenia, or nervous exhaustion, was applied to symptoms resembling CFS. In the 1930s through the 1950s outbreaks of disease marked by prolonged fatigue were reported in the United States and many other countries. Beginning in the early to mid-1980s interest in chronic fatigue syndrome was revived by reports in America and other countries of various outbreaks of long-term debilitating fatigue.

Unexplained chronic fatigue lasts for more than six months, impairs normal activities and has no identifiable medical or psychological problems to account for it. The condition is not considered to be chronic fatigue syndrome, however, unless it meets certain criteria. If doesn't then the condition is referred to as idiopathic chronic fatigue; idiopathic simply means that the cause is not known. It should be noted that six million patient visits are made each year because of fatigue, although only a very small percentage of these can be attributed to chronic fatigue syndrome.

Criteria for Chronic Fatigue Syndrome

Four or more of the following symptoms must have been present for longer than six months:

  1. short-term memory loss or a severe inability to concentrate that affects work, school, or other normal activities,
  2. sore throat,
  3. swollen lymph nodes (eg. in the neck or armpits),
  4. muscle pain,
  5. pain without redness or swelling in a number of joints,
  6. intense or changing patterns of headaches,
  7. unrefreshing sleep,
  8. after any exertion, weariness that lasts for more than a day.

The fatigue must be severe: sleep or rest does not relieve it; the fatigue is not the result of excessive work or exercise; the fatigue substantially impairs a person's ability to function normally at home, at work, and in social occasions. Even mild exercise often makes the symptoms, especially fatigue, much worse.

The fatigue must be a new, not lifelong, condition with a definite time of onset. The symptoms must persist. In ordinary infections, symptoms go away after a few days, but in CFS, fatigue and other symptoms recur or continue for months to years. Many patients experience symptoms as recurring bouts of flu-like illness, with each attack lasting from hours to weeks.

Symptoms similar in CFS, temporomandibular disorder and fibromyalgia

By Elda Hauschildt

CHICAGO: There is now preliminary evidence that patients with chronic fatigue syndrome, fibromyalgia and temporomandibular disorder share the same key symptoms.

These symptoms include generalized pain sensitivity, sleep and concentration difficulties, bowel complaints, and headache. Researchers also say it is apparent that seven other localized and systemic illnesses may occur at the same time as the three conditions.

These include chronic tension-type headache, irritable bowel syndrome, bladder pain syndrome/interstitial cystitis (BPS/IC), post-concussive syndrome, multiple chemical sensitivities, chronic pelvic pain and chronic low back pain.

Seattle researchers recruited 25 chronic fatigue patients, 22 fibromyalgia patients and 25 temporomandibular patients from hospital- based clinics. All of the patients were diagnosed by their physicians. The control group numbered 22 healthy subjects from a dermatology clinic.

All participants completed a 138-item symptom checklist. They then underwent brief physical examinations.

Most patients reported few past diagnoses of the 10 clinical conditions outside of their primary diagnosis. Patients diagnosed with each of the three main conditions were more likely than control subjects to meet lifetime symptom and diagnostic criteria for many of the other conditions.

The most striking finding was that of lifetime rates of irritable bowel syndrome. Researchers found the syndrome in 92 per cent of chronic fatigue, 77 per cent of fibromyalgia, and 64 per cent of temporomandibular disorder patients.

Archives of Internal Medicine, 2000; 160: 221-227