Many Canadians are affected by complex chronic diseases (CCD). CCD’s are illnesses that last a long time, require treatment and management, and often do not get better on their own. Some CCD’s are known as “syndromes”. A syndrome is when a distinct group of symptoms cause an illness and loss of function. Fibromyalgia (FM) and Myalgic Encephalomyelitis (ME), also called Chronic Fatigue Syndrome (CFS), are 2 conditions known as syndromes. Both of these syndromes have no blood or lab tests to confirm diagnosis.

Fibromyalgia

Fibromyalgia (FM) was recognized by the American College of Rheumatology as a true syndrome in 1990. FM can occur in both men and women, but women are more often affected. There is no known cause for this condition. Early diagnosis can help you avoid further complications and allows for better management of your symptoms.

The main symptom of FM is pain that is felt to all parts of your body and lasts for at least 3 months. Over time the pain becomes more constant, and it can affect more areas of your body. The location of the pain and the severity of the pain may also start to vary. Other symptoms of FM can include:

• fatigue (tiredness).
• trouble sleeping.
• memory problems or the inability to think clearly.
• mood disorders such as depression.

Symptoms, and the severity of symptoms, will vary from person to person. If you have FM, you may also have other health conditions such as irritable bowel syndrome (IBS), migraine headaches, and more. For more information, visit:

• BC Women’s Hospital + Health Centre: Fibromyalgia
• The Arthritis Society: Fibromyalgia
• Canadian Guidelines for the Diagnosis and Management of Fibromyalgia Syndrome in Adults

Myalgic Encephalomyelitis

Myalgic Encephalomyelitis (ME), also called Chronic Fatigue Syndrome (CFS), is now recognized as a medical condition. ME/CFS does not have a single cause. It usually occurs after having an infection, normally a viral infection. More research is still being done to learn about the condition. At this point, a diagnosis is based on the symptoms you describe to your health care provider, and by ruling out other conditions which could be causing these symptoms. In order to be diagnosed with ME/CFS, symptoms must be present for at least 6 months in adults and 3 months in children.

The main symptom of ME/CFS is fatigue (tiredness) following physical activity (post-exertion), or fatigue to a point that it is disabling. The fatigue can be severe enough to interrupt activities and relationships with others. Other symptoms can include:

• malaise (feeling generally unwell).
• flu-like symptoms.
• sleep problems.
• pain.
• memory or other cognitive problems.
• chemical sensitivities or intolerance.
• your body may not function normally.

Symptoms, and the severity of symptoms, will vary from person to person. Some people may recover completely from ME/CFS, while others do not. For more information, visit:

• BC Women’s Hospital + Health Centre: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.
• Health Canada: Chronic Fatigue Syndrome (Myalgic Encephalomyelitis)

Symptom Management

Since both FM and ME/CFS have similar symptoms, they also have similar management therapies. The goal of treatment is to relieve symptoms such as pain and fatigue, as well as other conditions such as depression that may develop as a result of these syndromes. For more information, and to find services and resources to help you, visit BC Women’s Hospital - Complex Chronic Diseases Program (CCDP)

Chronic Lyme Disease

Several diseases can be passed to humans from tick bites. The most well-known is Lyme disease.

Ticks from many areas of British Columbia carry Borrelia burgdorferi, the organism that causes Lyme disease. Dozens of Lyme disease cases have been identified in the past 15 years. Many people with Lyme disease have not travelled outside of the province, and it is likely they contracted the disease in B.C.

Not all ticks carry the bacteria for Lyme Disease, and there is only a very small chance of ticks giving it to you. However, since Lyme disease is such a serious disease, it is worth taking steps to avoid being bitten.

Some people who have had acute Lyme disease, may go on to develop chronic symptoms including fatigue, cognitive symptoms like “brain fog”, sleep disturbance and other unexplained symptoms. For more nformation, visit:

• BC Women’s Hospital - Symptoms Attributed to Chronic Lyme Disease
• BC Centre for Disease Control: Lyme Disease (Borrelia burgdorferi infection)
• Health Canada: Lyme disease

Last Reviewed: April 2019