Fibromyalgia and chronic fatigue syndrome: an update for athletic trainers

Primary fibromyalgia syndrome (PFS) and chronic fatigue syndrome (CFS) are clinical conditions characterized by a variety of symptoms, including prominent fatigue, myalgia, and sleep disturbances. Although the incidence of these syndromes is infrequent, when manifested, they can completely disrupt the life and career of those affected. When they are manifested within the physically active population, they can jeoardize the futures of the most promising athletes.

Public documents available from the U. S. Department of Health and Human Services, Public Health Services, and the National Institutes of Health were researched. MEDLINE and CINAHL were researched back to 1988 with the following key words: chronic fatigue syndrome, primary fibromyalgia syndrome, sports participant, physically active, mononucleosis, myalgia, rehabilitation, reconditioning, athlete, and sports medicine.

The definition of CFS in 1988 included disabling fatigue of unknown case of at least 6 months' duration. Primary fibromyalgia syndrome was once considered a subsyndrome of CFS. PFS is diagnostically characterized as a nonarticular rheumatism. The "yuppie flu" was a catch phrase of the 1980s for CFS, which was then named chronic Epstein-Barr virus syndrome. Initially the condition was thought of as simple infectious mononucleosis, but we now have a medically defined set of symptoms to describe what are called CFS and PFS. Training interruptions, feelings of loss of control, and concerns over possible psychologic or psychiatric referral can occur. Relaxation therapy, exercise, image therapy, serotonin supplementation, and antiviral therapy are in clinical trials now as the best options for management of CFS and PFS.

Current statistics on those affected by CFS and PFS in the general population are less than 2% for CFS and 2% for PFS. Comprehensive documentation of signs, symptoms, and complaints, along with judicious physician follow-up, are important during the course of treatment leading up to and following a diagnosis of CFS or PFS. Professional evaluation of the affected player's neuropsychological status is important and necessary as a care plan is developed.