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Evidence for generalized hyperalgesia in chronic fatigue syndrome: a case control study

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Abstract

Several studies provided evidence for generalized hyperalgesia in fibromyalgia or whiplash-associated disorders. In chronic fatigue syndrome, however, pain is a frequently reported complaint, but up to now, evidence for generalized hyperalgesia is lacking. The aim of this study is to examine whether the pressure pain thresholds (PPTs) at both symptomatic and asymptomatic sites differ in chronic fatigue syndrome (CFS) patients with chronic pain, compared to healthy controls. Therefore, 30 CFS patients with chronic pain and 30 age- and gender-matched healthy controls indicated on a Margolis Pain Diagram where they felt pain lasting longer than 24 h in the past 4 weeks. After completing a test battery of questionnaires evaluating pain cognitions, functional status and symptomatology, a blinded researcher assessed PPTs bilaterally at seven non-specific sites on both trunk and extremities. PPTs were compared for the two complete groups. In addition, PPTs of patients and controls who did not report pain in a respective zone were compared. PPTs of the patients were significantly lower (p < 0.001) compared to those of the control group, also when pain-free samples per zone were compared (p < 0.001). The mean PPT was 3.30 kg/cm2 in all CFS patients and 8.09 kg/cm2 in the controls. No confounding factors responsible for the observed differences, as, e.g., catastrophizing and depression, could be revealed. These findings provide evidence for the existence of hyperalgesia even in asymptomatic areas (generalized secondary hyperalgesia). The generalized hyperalgesia may represent the involvement of a sensitized central nervous system.

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Acknowledgments

Mira Meeus is financially supported by a PhD grant supplied by the Higher Institute of Physiotherapy, Department of Health Sciences, Artesis University College Antwerp, Antwerp, Belgium (G 807) and co-financed by Faculty of Physical Education and Physiotherapy – Vrije Universiteit Brussel (VUB), Brussels, Belgium (OZR project OZ.R. 1234/MFYS Wer2). The authors are grateful to Kenny De Meirleir for diagnosing the patients with CFS, and to Andre Farasyn for kindly providing his expertise on PPT assessment.

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Authors and Affiliations

  1. Department of Health Sciences, Division of Musculoskeletal Physiotherapy, Artesis Hogeschool Antwerpen (AHA), Van Aertselaerstraat 31, 2170, Merksem, Belgium

    Mira Meeus, Jo Nijs, Sven Huybrechts & Steven Truijen

  2. Department of Human Physiology, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1050, Brussels, Belgium

    Mira Meeus & Jo Nijs

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  1. Mira Meeus
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  2. Jo Nijs
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Correspondence to Jo Nijs.

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Meeus, M., Nijs, J., Huybrechts, S. et al. Evidence for generalized hyperalgesia in chronic fatigue syndrome: a case control study. Clin Rheumatol 29, 393–398 (2010). https://doi.org/10.1007/s10067-009-1339-0

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  • DOI: https://doi.org/10.1007/s10067-009-1339-0

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