OVERVIEW
Chronic fatigue syndrome (CFS) and its often simultaneously present cousin, fibromyalgia syndrome (FMS), are common names for an overlapping spectrum of disabling syndromes. It is estimated that FMS alone affects three to six million Americans, causing more disability than rheumatoid arthritis, and later research suggests a prevalence of CFS/FMS and/or disabling fatigue ranging from 7.3% to 12.9% across different countries.1,2 The majority of patients I see in clinical practice who have FMS also have CFS.3 Myofascial pain syndrome (MPS), pain caused by a localized area of muscle shortening, often shares many of the same underlying metabolic processes as FMS4 and affects many millions more.5 Structural abnormalities are more of a concern in MPS; however, because this article discusses the metabolic problems often seen in all three processes, I will often refer to the three (CFS/FMS/MPS) together.
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