Fibromyalgia is not just about muscle pain. There are many different symptoms of fibromyalgia. It is not necessary to have every symptom listed below in order to have the disease.
Some common symptoms of fibromyalgia include the following:
- Chronic pain in the muscles associated with tightness in the muscles and muscle spasm. Chronic musculoskeletal pain is the most characteristic symptom seen in almost everyone who has fibromyalgia. This is what usually causes the individual to seek medical attention in the first place. Fibromyalgia pain is widespread, felt in almost all body areas. It is often described as throbbing, aching, or dull pain although it can consist of deeply sharp pains as well. The pain is usually felt in the muscles and soft tissues of the body and will come and go in an irregular pattern. Some people have pain throughout their entire body.
- Tender points in the body. Besides the intense muscle soreness and aching of the body, those with fibromyalgia have localized areas of the body, usually near joints, that are extremely tender to the touch, especially when pushed on with the fingers. This pain is not associated with pain in the joints themselves but is found in the soft tissue that surrounds the joints, including the tendons and ligaments. The tender points are usually superficial in location, near the skin’s surface. They are also not randomly occurring tender points but are in predictable areas of the body as evidenced by the exam, which will be elucidated below. Pressure on these specific tender points can result in extreme pain.
- Fatigue, which can be moderate or severe, associated with decreased energy levels. Fatigue is the second most common complaint in fibromyalgia after pain symptoms. The fatigue tends to linger and be unassociated with the amount of rest or sleep the person gets. Some with fibromyalgia feel as though the fatigue reminds them of the type of fatigue experienced when one had the flu. Others say it feels as though the fatigue is similar to the fatigue experienced when working too long after getting insufficient sleep. The fatigue is worse when getting up in the morning and occurs after a minimum amount of activity, such as housecleaning or shopping for groceries. People with fibromyalgia are too tired to exercise or to engage in sex. They tend to be too tired to start on a project, even something they otherwise would look forward to. They are often too tired to sustain an adequate amount of productivity at work.
- Insomnia or the inability to get an adequate amount of sleep. They often feel just as fatigued upon arising as they did when going to sleep. There may be difficulty getting to sleep in the first place associated with sleep that is easily disturbed, light, and uncomfortable. In the morning, they may feel as though they had unrefreshing sleep and may feel exhausted. The lack of sleep contributes to the chronic fatigue the fibromyalgia sufferers often experience.
There are actual EEG changes experienced when fibromyalgia sufferers are sleeping. They have EEG changes that mimic the awake state, even as the fibromyalgia sufferer appears to be sleeping. The EEG changes associated with deep sleep are somewhat lacking when a person with fibromyalgia is sleeping, limiting the amount of time the individual spends in the deepest stages of sleep. This means that the body cannot rejuvenate itself and the sufferer feels tired in the morning.
- Muscle stiffness after waking up or when remaining in one position for a long period of time. Research has shown that many people with fibromyalgia feel stiff in the morning when they first get up. The stiffness extends to include the arms, legs, and back, giving the sufferer the feeling that they need to loosen up their muscles before being able to go about their regular daily activities.
The stiffness may persist for only a few minutes after arising or can last up to twenty minutes after getting out of bed in the morning. People with severe fibromyalgia feel stiff all the time and no amount of relaxation or stretching appears to relieve the muscle stiffness.
The type of stiffness experienced by those with fibromyalgia is different from the minor aching and muscle stiffness many people feel after a restless night of sleep. Rather, it is stiffness that is typical of those who have inflammatory arthritis or rheumatoid arthritis, which is difficult to get rid of.
- Problems with memory, concentration, and the performance of basic mental tasks. This is often referred to as having “fibro fog” and interferes with the fibromyalgia sufferer’s ability to be productive at work. Tasks take longer to accomplish and memory difficulties make it difficult to memorize the various steps of a given task given to the individual. Poor concentration can be profound so that the individual finds it difficult to get anything accomplished.
- Depressive symptoms. People with fibromyalgia often complain of symptoms consistent with depression. In fact, nearly half of all people who have fibromyalgia already have the diagnosis of depression or an anxiety disorder at the time they are diagnosed with fibromyalgia syndrome.
Researchers aren’t sure whether or not the stress associated with constant fatigue and ongoing pain causes an anxiety state seen in fibromyalgia. It is also possible that the pain from fibromyalgia results in less activity and an increase in social withdrawal that can lead to depressive symptoms.
Depression, whether it predates the diagnosis of fibromyalgia or occurs after the person has been diagnosed with fibromyalgia, may be a part of the syndrome itself and may be related to brain changes common in the two diseases. The same is true with anxiety, which may be an actual part of the disease of fibromyalgia itself.
- Swelling and tingling of the hands. Fibromyalgia sufferers often exhibit neurological complaints, including burning pain, tingling, and numbness of the hands. No one knows the cause of these neurological complaints even though they are very common in those who have fibromyalgia. These sensations, known as paresthesia, seem to occur at the same time a fibromyalgia sufferer experiences stiffness in the morning, although some people have paresthesia symptoms lasting most of the day.
- Chronic headaches. People with fibromyalgia are more prone to migraine or tension headaches than those who do not have fibromyalgia. Up to 70 percent of all fibromyalgia, patients also complain of chronic headaches.
The headaches are often related to the chronic pain in the upper aspect of the back and the neck in those who have fibromyalgia. This type of pain leads to inflammation of the scalp muscles, which is the cause of tension headaches (muscle-contraction headaches). There are also trigger points in the back of the head and neck, which can lead to muscle contraction headaches.
Even though headaches are often associated with fibromyalgia, any chronic headache condition should be evaluated by a physician to make sure the headaches are solely related to fibromyalgia and not to some other condition or disease.
- Irritable bowel syndrome symptoms. People with fibromyalgia often complain of nausea, bloating, abdominal pain, and constipation. Some have constipation alternating with diarrhea, which is a typical symptom of irritable bowel syndrome. These gastrointestinal symptoms are found in about 40-70 percent of fibromyalgia patients. They often complain of indigestion, acid reflux, or GERD, which stands for “gastroesophageal reflux disease.”
- Facial and jaw tenderness. People with fibromyalgia can have pain in the temporomandibular joints or across the facial muscles. Some patients will meet the criteria for having temporomandibular joint disease (TMJ) along with the criteria for fibromyalgia.
- Oversensitivity to stimuli. Those with fibromyalgia will complain of oversensitivity to certain odors, bright lights, loud noises, cold air, certain foods, or medications. They may be intolerant to another’s perfume or find themselves only comfortable in a warm, dark, and quiet place. This limits the fibromyalgia patient’s ability to participate in many areas of normal daily activities.
- Irritable bladder symptoms. Fibromyalgia patients often find themselves with an increase in urinary frequency an urgency. They may feel as though they have a bladder infection when the ordinary tests used to diagnose bladder infections are negative for infection. They may have difficulty getting to the restroom in time, leading to urinary urge incontinence. Unfortunately, medications for urinary urge incontinence often exacerbate symptoms of constipation so these medications are often not indicated in those fibromyalgia patients with irritable bowel syndrome symptoms.
- Increased menstrual cramps. Women with fibromyalgia who are also within childbearing age often complain of severe menstrual cramps and heavy vaginal flow. These menstrual symptoms are often long lasting—occurring up until the time of menopause. When menopause occurs, they often have a greater number and intensity of hot flashes and night sweats when compared to those who do not have fibromyalgia.
- Decreased tolerance for exercise. Fibromyalgia patients often do not tolerate the rigors of exercise, many complaining of increased pain in the muscles following exercise. Even though you will see that exercise is effective in the management of fibromyalgia, it is often difficult to get started in an exercise program when the patient feels as though the exercise will worsen their symptoms.
- A sensation of swelling of the feet and hands. Fibromyalgia patients often feel as though their hands and feet are swollen although, to physical appearances, no swelling can be detected.
- Symptoms of restless legs syndrome. Restless legs syndrome is condition where the legs feel very uncomfortable and only experience relief of these symptoms when the legs are moved or shaken. The individual ends up tossing and turning, especially at night because keeping the legs still is an intolerable feeling.
Fibromyalgia patients often feel symptoms of restless leg syndrome, which may worsen at nighttime or when the patient is trying to sleep. This can exacerbate the insomnia symptoms typical in those who have fibromyalgia.