Functional Improvement Is Accompanied by Reduced Pain in Adolescent Chronic Fatigue Syndrome

Abstract

Dear Editor: Chronic fatigue syndrome (CFS) in adolescents is a complex, disabling condition characterized by severe and unexplained fatigue lasting more than 6 months, and often accompanied by pain symptoms. CFS in adolescents has substantial long-term consequences for educational and social development ⇓. Chronic pain symptoms in CFS are disabling and affect physical and social functioning ⇓. Adult patients with CFS show lower pain thresholds than healthy subjects ⇓. In a recently published review about pain in patients with CFS, Nijs et al. stated that pain appears to be one out of many symptoms related to central sensitization in adult CFS ⇓. They concluded that pain-catastrophizing thoughts and depression partly account for these pain symptoms. They suggested that it is important to understand the symptoms of pain in CFS better in order to assess whether it requires a specific treatment approach other than the main treatment focused on fatigue ⇓. Previous research has suggested to view the pathophysiological state of pain in CFS as an increase in the excitability and synaptic efficacy of neurons in central nociceptive pathways ⇓. We present original data on pain symptoms in adolescent CFS and their relation to treatment focused on fatigue. We hypothesized that adolescent CFS patients have a lowered pain threshold at the time of diagnosis and that both pain experience and pain threshold improve when CFS is successfully treated. Between November 2008 and February 2010, 83 adolescents (12–18 years) participating in the Fatigue In Teenagers on the interNET (FITNET) trial ⇓ were invited to participate in this longitudinal study on pain in adolescents with CFS, when attending their initial assessment at the University Medical Center Utrecht for the original FITNET trial ⇓. All patients agreed to participate (100%). They all complied with the U.S. Centers …