Fibromyalgia Syndrome or Chronic Fatigue Syndrome/Myalgic Encephalomyelitis and Factors Influencing Work Disability in Women

Abstract

Fibromyalgia is a complex chronic pain syndrome characterized by widespread muscle pain, tenderness, and fatigue. Women with fibromyalgia report that symptoms limiting their work ability include pain, tiredness, muscle weakness, and memory and concentration difficulties. Work tasks perceived as “difficult” for women with fibromyalgia are repetitive movements, static muscle work as when holding, standing, or sitting in the same positions for fairly long periods, heavy work, working above shoulder level, power gripping, and frequent carrying and lifting. These difficulties reflect the fibromyalgia pathophysiology. To be able to remain at work, women with fibromyalgia need workplaces, which are flexible and adjustable. They need to be able to change and alternate positions and tasks, take short breaks, and, in many cases, reduce working hours. With appropriate support and adaptation, most are able to continue working to some extent.The prognosis for post-viral fatigue chronic fatigue syndrome/myalgic encephalomyelitis is considered poor if untreated. Many women with chronic fatigue syndrome/myalgic encephalomyelitis have low work capacity and are not in work. One problem in reviewing studies assessing their likelihood of return to work is the variability in the criteria for inclusion. Thus, the proportion of patients with stress-related chronic fatigue in chronic fatigue syndrome/myalgic encephalomyelitis studies is bound to affect the return-to-work rates. Recent research has strengthened the view that there could be a clinically and scientifically meaningful distinction between chronic fatigue syndrome/myalgic encephalomyelitis, usually with acute onset after infection and hypothetically a neuroimmunological disorder and, on the other hand, stress-related chronic fatigue. Current evidence for activity improvements and work resumption after rehabilitation is reviewed for patients with chronic fatigue syndrome/myalgic encephalomyelitis.