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Pain inhibition and postexertional malaise in myalgic encephalomyelitis/chronic fatigue syndrome: An experimental study' – Source: Journal of Internal Medicine, Mar 2010

  [ 100 votes ]   [ 1 Comment ]
By Jessica Van Oosterwijck, et al. • • April 20, 2010

Objectives: To examine the efficacy of the pain inhibitory systems in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) during two different types of exercise and to examine whether the (mal)functioning of pain inhibitory systems is associated with symptom increases following exercise.

Design: A controlled experimental study.

Setting and subjects: Twenty-two women with ME/CFS and 22 healthy sedentary controls were studied at the Department of Human Physiology, Vrije Universiteit Brussel.Interventions.

All subjects performed a submaximal exercise test and a self-paced, physiologically limited exercise test on a cycle ergometer. The exercise tests were undertaken with continuous cardiorespiratory monitoring. Before and after the exercise bouts, subjects filled out questionnaires to assess health status, and underwent pressure pain threshold measurements. Throughout the study, subjects' activity levels were assessed using accelerometry.


• In patients with ME/CFS, pain thresholds decreased following both types of exercise, whereas they increased in healthy subjects.

• This was accompanied by a worsening of the ME/CFS symptom complex post-exercise.

• Decreased pressure thresholds during submaximal exercise were associated with postexertional fatigue in the ME/CFS group (r = 0.454; P = 0.034).

Conclusions: These observations indicate the presence of abnormal central pain processing during exercise in patients with ME/CFS and demonstrate that both submaximal exercise and self-paced, physiologically limited exercise trigger postexertional malaise in these patients.

Further study is required to identify specific modes and intensity of exercise that can be performed in people with ME/CFS without exacerbating symptoms.

Source: Journal of Internal Medicine, doi:10.1111/j.1365-2796.2010.02228.x, by Van Oosterwijck J, Nijs J, Meeus M, Lefever I, Huybrechts L, Lambrecht L, Paul L. Vrije Universiteit Brussel; Artesis University College Antwerp; University Hospital Brussels; Private Practice For Internal Medicine, Ghent/Aalst; CVS Contactgroep, Bruges, Belgium; University of Glasgow, Glasgow, UK. [Email:]

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Article Comments Post a Comment

Pain inhibition and postexertional malaise in myalgic encephalomyelitis/chronic fatigue syndrome
Posted by: Laehcar
Apr 21, 2010
I have had cfs for over twenty-five years and have long suspected dopamine/endorphin depletion to be a factor in chronic fatigue syndrome and an inability to restore dopamine levels in the brain. Dopamine can act like a brake, which might help explain why some with cfs experience post-exertional fatigue and pain syndromes. If you are depleted in dopamine, the body has nothing to work with to control pain etc. (running on empty). Anything that increases the depletion of dopamine/endorphins (stress, exercise etc.) will cause more fatigue, flu-like-symptoms and pain. The immune system becomes hyper-reactive.
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