Typical document of what is produced in the US, without being perfect, I think it contains some good advice.
But, something raised my eyebrows ... :
" Be aware of common comorbid conditions: small fiber neuropathies, hypermobility, autoimmune thyroid disease, euthyroid sick syndrome, Sicca Syndrome,
pain amplification disorders (to include FM)... "
And what does the ACR (American College of Rheumatology) say about
Amplified Musculoskeletal Pain Syndrome (AMPS)?
" Treatment of AMPS consists of a non-pharmacologic approach involving cognitive behavioral therapy, physical and occupational therapy, and regular aerobic exercise with a focus on stress reduction. Since AMPS can often affect the entire family, family counseling is often recommended as well. Typically, once a clear diagnosis is established and all unnecessary medications and testing modalities are stopped, the burden of the ‘unknown illness’ is lifted which can be a relief. Pain management recommendations are heavily weighted towards graded (gradually increasing) exercise programs, regular daily activity in the form of functional aerobic training, desensitization for allodynia and psychotherapy."
https://www.rheumatology.org/I-Am-A.../Amplified-Musculoskeletal-Pain-Syndrome-AMPS
Rather contradictory, with ME, isn't it? I don't quite understand how a person can have ME and FM simultaneously: either they have ME (with PEM) with or without pain, or they have FM therefore without PEM. The document strikes me as confused on this point.