Overview
Chronic Fatigue Syndrome (CFS) and Fibromyalgia are both long-term conditions that cause significant fatigue and impact daily life, but they differ in core symptoms and mechanisms. CFS is defined by extreme, persistent fatigue that worsens after physical or mental activity (post-exertional malaise) and is not relieved by rest. Fibromyalgia is primarily characterized by widespread musculoskeletal pain, along with fatigue, sleep disturbances, and cognitive issues. While they often overlap, pain is more central in fibromyalgia, and fatigue is more prominent in CFS.
Disease Summaries
Chronic Fatigue Syndrome: This is a condition in which fatigue and low energy levels last for an extended period (months to years). It can greatly impair patients' daily activities. The physical causes are currently not well understood.
Fibromyalgia: This is a chronic condition characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties. Patients often experience tender points throughout their body and may have symptoms that wax and wane over time. While the exact cause remains unknown, research suggests it involves how the brain and spinal cord process pain signals, potentially triggered by genetics, infections, or physical/emotional trauma.
Comparing Symptoms
Overlapping Symptoms
- Persistent fatigue
- Cognitive difficulties or brain fog
- Sleep disturbances
- Headaches
- Sensitivity to light, noise, or temperature
Chronic Fatigue Syndrome Specific Symptoms
- Debilitating fatigue not improved by rest
- Post-exertional malaise (worsening after activity)
- Dizziness or lightheadedness (especially when standing)
- Sore throat or swollen lymph nodes
- Muscle or joint pain without inflammation
Fibromyalgia Specific Symptoms
- Widespread musculoskeletal pain
- Tender points across the body
- Morning stiffness
- Irritable bowel symptoms
- Tingling or numbness in hands and feet
Treatment Approaches
Chronic Fatigue Syndrome Treatment Approaches
There is no specific cure for this condition. Often, patients find relief with lifestyle changes such as ensuring adequate sleep, spacing out activities, and avoiding alcohol, smoking, and caffeine.
Fibromyalgia Treatment Approaches
Treatment involves a multi-faceted approach including medications for pain and sleep problems, physical therapy, and exercise programs. Stress-reduction techniques, cognitive behavioral therapy, and alternative therapies like acupuncture can help manage symptoms. Lifestyle modifications including regular sleep schedules and gentle exercise are crucial.
Reviewed By:

Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.

Shohei Harase, MD (Neurology)
Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.
Content updated on May 1, 2025
Following the Medical Content Editorial Policy
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https://www.acpjournals.org/doi/10.7326/AITC202003030Turner-Stokes L, Wade DT. Updated NICE guidance on chronic fatigue syndrome. BMJ. 2020 Dec 16;371:m4774. doi: 10.1136/bmj.m4774. PMID: 33328173.
https://www.bmj.com/content/371/bmj.m4774