Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome
Open accessAbstract
In addition to the debilitating fatigue, the majority of patients with chronic fatigue syndrome (CFS) experience chronic widespread pain. These pain complaints show the greatest overlap between CFS and fibromyalgia (FM). Although the literature provides evidence for central sensitization as cause for the musculoskeletal pain in FM, in CFS this evidence is currently lacking, despite the observed similarities in both diseases. The knowledge concerning the physiological mechanism of central sensitization, the pathophysiology and the pain processing in FM, and the knowledge on the pathophysiology of CFS lead to the hypothesis that central sensitization is also responsible for the sustaining pain complaints in CFS. This hypothesis is based on the hyperalgesia and allodynia reported in CFS, on the elevated concentrations of nitric oxide presented in the blood of CFS patients, on the typical personality styles seen in CFS and on the brain abnormalities shown on brain images. To examine the present hypothesis more research is required. Further investigations could use similar protocols to those already used in studies on pain in FM like, for example, studies on temporal summation, spatial summation, the role of psychosocial aspects in chronic pain, etc.
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Recent studies suggest a potential correlation between physiological stress and FSS, with physical inactivity as a potential covariate.
“Recent studies suggest a potential correlation between physiological stress and FSS, with physical inactivity as a potential covariate.13–16”
From Comparing group-based acceptance and commitment therapy (ACT) with enhanced usual care for adolescents with functional somatic syndromes: A study protocol for a randomised trial (2016) · cites this paper as [15]
The Evidence in FM section says exposure to stressful situations can exacerbate fibromyalgia symptoms, including pain. It does not establish a correlation between physiological stress and functional somatic syndromes broadly, or identify physical inactivity as a potential covariate; its exercise passages concern pain responses to exercise instead. Page numbers are unavailable in our copy. (LLM, conf=0.78)
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- Authors
- Meeus, M., & Nijs, J.
- Affiliations
- Vrije Universiteit Brussel (BE)
- Corresponding author
- Nijs, Jo
- ORCID
- Venue
- Clinical Rheumatology
- Published
- 2006-11-18
- Volume
- 26
- Issue
- 4
- Pages
- 465-473
- ISSN
- 0770-3198 (ISSN-L)
- 1434-9949
- PMC
- PMC1820749
- OpenAlex
- W1992707234
- Cited by
- 541
- References
- 102
- Citations by year
- 2026: 21 · 2025: 22 · 2024: 18 · 2023: 25 · 2022: 29 · 2021: 43 · 2020: 43 · 2019: 33 · 2018: 27 · 2017: 33 · 2016: 17 · 2015: 36 · 2014: 34 · 2013: 35 · 2012: 30
- FWCI
- 1.66
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Rheumatology (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- central sensitization, chronic widespread pain, fibromyalgia, chronic fatigue syndrome, hyperalgesia, allodynia, nitric oxide, personality, brain abnormalities, pain processing, biopsychosocial model, temporal summation, spatial summation
- MeSH terms
- Fibromyalgia, Humans, Hyperalgesia, Nervous System Physiological Phenomena, Pain, Perception, Fatigue Syndrome, Chronic, Referred Pain
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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