Fibromyalgia is a chronic pain condition and, not surprisingly, pain is its primary symptom. In fact, the only symptom included in the original diagnostic criteria established by the American College of Rheumatology in 1990 was pain. However, the proposed new diagnostic criteria also takes into consideration other significant symptoms that usually occur with fibromyalgia in addition to the pain.
Following are the symptoms most commonly found in people with fibromyalgia. Not every person with FM will have all of the symptoms and the severity of each symptom will vary from person to person.
_Pain: _ The pain of fibromyalgia is widespread, chronic and can range in intensity from mild to profound. Most FM patients describe having an aching feeling that encompases their whole body, much like it feels when you have the flu. People with fibromyalgia often report waking with severe pain and stiffness. In addition to the aching, FM patients usually have more localized pain as well that may migrate or move from one location to another. Those pains have been described in many ways, such as throbbing, sharp, burning, shooting or stabbing pains.
_Fatigue: _ Fatigue is often the most difficult symptom to describe to others because people tend to think that you're just tired. However, the fatigue of fibromyalgia is so much more than just being tired it is a pervasive, all-encompassing exhaustion that can interfere with even the most basic and simple daily activities. The fatigue of FM has been described by patients as feeling like someone pulled their plug and disconnected them from their power source. In some cases the fatigue of FM can be more debilitating and interfere more with everyday life than the pain.
_Sleep Dysfunction: _ Most people with fibromyalgia have difficulty sleeping and do not awaken feeling refreshed. Research studies have shown that FM patients spend little or no time in deep, stage four sleep. Many have a sleep disorder called the Alpha EEG anomaly in which their deep sleep is repeatedly interrupted by bursts of awake-like brain activity. Since this is the stage of sleep during which the body replenishes itself, fibromyalgia patients are not able to get restful, restorative sleep.
**Cognitive Dysfunction: ** Many people with FM find that their cognitive functioning processes are not working well. They experience memory problems and have difficulty concentrating. FM patients often describe these problems as having "fibro-fog" or "brain-fog" because they feel like their minds are clouded by a thick fog and they can't think clearly.
_Sensitivity to Cold and/or Heat: _ Extreme sensitivity to cold or heat - or sometimes both - is a common complaint of people with FM. Temperatures that might be within the comfort range of the average person can be terribly uncomfortable for the person with FM. For some, this sensitivity can be so severe that it seriously interferes with their lives, forcing them to stay at home whenever the temperature goes above or below a certain level.
_Depressed Mood/Anxiety: _ At one time fibromyalgia symptoms were thought to be manifestations of depression, however, we now know that is not the case. As with most chronic illnesses, though, it is not uncommon for people with FM to have some depression and/or anxiety. Often people with FM have lower than normal serotonin levels, which is also associated with depression.
_Digestive Problems: _ It is not uncommon for people with FM to have a variety of digestive problems. Abdomminal pain, bloating, constipation, diarrhea and indigestion are some of the digestive discomforts people with FM may experience. Irritable bowel syndrome is an overlapping condition that is frequently diagnosed in FM patients.
_Headaches: _ A number of people with FM report having chronic head pain. For many of them, the head pain is significant enough to be diagnosed as a separate, overlapping condition such as tension headaches, cluster headaches, Migraines, etc.
_Hypersensitivity: _ In addition to having a hypersensitivity to pain and temperature, many people with FM find that one or more of their other senses are hypersensitive as well. For example, they may be extremely sensitive to bright lights or strong smells. People with FM also tend to have allergic reactions to a number of things such as foods, pollen, medications, etc.
Fibromyalgia rarely stands alone. People who have fibromyalgia almost always have one or more overlapping (comorbid) conditions. Sometimes thought to be symptoms of FM, they are actually distinct conditions that exist alongside fibromyalgia. Many of these conditions fall within a category that has been termed central sensitivity syndromes, meaning they involve a hypersensitive or overactive central nervous system.
Some of the more common conditions that overlap with fibromyalgia are:
Chronic Fatigue Syndrome (ME/CFS)
Complex Regional Pain Syndrome (aka Reflex Sympathetic Dystrophy)
Hypermobility Syndrome (including Elhers-Danlos Syndrome)
Irritable Bowel Syndrome
Multiple Chemical Sensitivities
Myofascial Pain Syndrome
Restless Leg Syndrome
Temporomandibular Joint Dysfunction (TMJ)
For a more complete list of overlapping conditions, please see the National Fibromyalgia & Chronic Pain Association's Overlapping Conditions Directory.
Makeover, M. E. National Institutes of Health, U.S. National Library of Medicine. (2011). Fibromyalgia. Washington, DC: MedlinePlus.