What conditions can co-exist with fibromyalgia, myofascial pain, or ME/CFS?

Akash Bajaj, MD

Overlapping (comorbid) conditions are ailments that frequently occur together. Fibromyalgia syndrome (FMS) and chronic fatigue syndrome (CFS or ME/CFS) are generally considered overlapping conditions. FMS and ME/CFS also have a host of other overlapping conditions associated with them. These include other pain disorders, sleep problems, major depression, nervous system disorders, digestive problems and menstrual problems.


Many people with FMS and ME/CFS also have other chronic pain conditions that need to be diagnosed and properly treated. Often, successfully treating other sources of pain can help alleviate FMS and ME/CFS symptoms.

Myofascial pain syndrome

Myofascial pain syndrome (MPS, sometimes called "chronic myofascial pain") is frequently confused with fibromyalgia, but they are different conditions. In MPS, muscles and connective tissues (which make up the fascia) develop what are called trigger points. A trigger point is often a small, hard knot, about the size of a pencil eraser that you may be able to feel under your skin. Sometimes the knot itself is painful, especially when you press on it, but it often causes pain in another area.

  • Learn more about myofascial pain syndrome, including treatments, possible causes, how it's diagnosed, and how it interacts with fibromyalgia: Fibromyalgia & Myofascial Pain Syndrome

Chronic headache

Some researchers believe that people with chronic headaches, such as migraines, and those with FMS may share common defects in systems that regulate specific chemical messengers in the brain, such as serotonin and epinephrine (adrenaline). Doctors have found low levels of magnesium in both groups as well, and when chronic migraine sufferers don't respond to usual therapies it sometimes leads to a diagnosis of FMS. Chronic headache frequently occurs with ME/CFS as well and can be relevant to diagnosing ME/CFS.

Migraine symptoms include heightened sensitivity to light and sound, nausea, vision problems such as auras or tunnel vision, difficulty speaking, and intense pain that's stronger on one side of the head.

Multiple chemical sensitivity

Multiple chemical sensitivity (MCS) causes similar symptoms to ME/CFS and FMS, but with the trigger being exposure to certain chemicals, such as those found in perfumes, adhesives and cleaning products. Because everyone is exposed to a huge variety of chemicals every day, it can be extremely difficult to identify which ones are causing the symptoms.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.