Fibromyalgia (FM) is also a recently coined term to describe widespread muscular pain and tender points. Pain is generally felt all over the body although it may start in one particular area such as the neck or shoulders. FM pain has a variable description including: burning, radiating, gnawing, sore stiff and aching muscles. It often varies according to the day, activity level, weather, sleep patterns and STRESS LEVELS. Most FM patients state that some degree of pain is always present and that they feel almost “flu like.” About 90% of FM patients describe moderate or severe fatigue with lack of energy, decreased exercise endurance, or the kind of exhaustion felt with the flu or lack of sleep. Generally FM patients wake up feeling tired and this may be due to the fact that sleep studies have demonstrated an abnormal sleep pattern with particular interruption in their deep sleep patterns. In both CFS and FM, it is not uncommon for people to also experience cognitive abnormalities in the form of poor memory, difficulty concentrating, mood liability and general confusion. Again, these are all characteristics of an “infection like” syndrome or environmental illness or a combination of both. The challenge then becomes to identify what pathogen(s) a patient has, in order to begin addressing the etiology of symptoms. Clearly the treatment for various infections is different, especially with regard to viral versus bacterial infections.
Therefore, the argument can be made that CFS and FM are simply a constellation of symptoms particular to a patient that arise as the result of exposure to a specific pathogen. A pathogen may also interact with the genetic makeup of an individual which would explain the vast symptom variability in this patient population.  Proper identification of the infection causing the symptoms is most important then, if healing and return to function is to take place.