Mechanisms Explaining Muscle Fatigue and Muscle Pain in Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a Review of Recent Findings

  • Morris Gerwyn
  • Michael MaesEmail author
Chronic Pain (R Staud, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Chronic Pain


Purpose of Review

Here, we review potential causes of muscle dysfunction seen in many patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) such as the effects of oxidative and nitrosative stress (O&NS) and mitochondrial impairments together with reduced heat shock protein production and a range of metabolic abnormalities.

Recent Findings

Several studies published in the last few years have highlighted the existence of chronic O&NS, inflammation, impaired mitochondrial function and reduced heat shock protein production in many patients with ME/CFS. These studies have also highlighted the detrimental effects of chronically elevated O&NS on muscle functions such as reducing the time to muscle fatigue during exercise and impairing muscle contractility. Mechanisms have also been revealed by which chronic O&NS and or impaired heat shock production may impair muscle repair following exercise and indeed the adaptive responses in the striated muscle to acute and chronic increases in physical activity.


The presence of chronic O&NS, low-grade inflammation and impaired heat shock protein production may well explain the objective findings of increased muscle fatigue, impaired contractility and multiple dimensions of exercise intolerance in many patients with ME/CFS.


Chronic fatigue Muscle Cytokines Oxidative Nitrosative Disability 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors


There was no specific financial support for this specific research.


Recently published papers of particular interest have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Tir Na NogLlanelliUK
  2. 2.IMPACT Strategic Research CentreDeakin University, School of Medicine and Barwon HealthGeelongAustralia

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