Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Fibromyalgia: Definitions, Similarities, and Differences

Clin Ther. 2019 Apr;41(4):612-618. doi: 10.1016/j.clinthera.2018.12.016. Epub 2019 Feb 20.


This commentary presents a simplified way of making the diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) using the 1994 Centers for Disease Control and Prevention case definition. The format used can easily be modified for other case definitions. The commentary then discusses whether ME/CFS is the same or a different illness from fibromyalgia. Because overlap exists between the 2 syndromes, some investigators have posited that they are variants of the same illness. I have viewed this as an empirically testable hypothesis and have summoned considerable amounts of data that suggest that the 2 illnesses differ. Were differences to exist, that would suggest different pathophysiologic processes for each, leading to different treatments.

Keywords: fatigue; overlap; pain; unexplained illness.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Fatigue Syndrome, Chronic / diagnosis*
  • Fibromyalgia / diagnosis*
  • Humans