Fibromyalgia Symptoms

Fibromyalgia Symptoms

Fibromyalgia symptoms are quite common but non-specific. However, the constellation of symptoms can often suggest a diagnosis of fibromyalgia.

Main Symptoms of Fibromyalgia

The four cardinal features of fibromyalgia include:

  1. Pain
    The "pain" is typically widespread or generalized and often axial (such as low back pain). It is interpreted to be deep and muscular in origin and the patient may also report subjective weakness.

    Approximately 25% of fibromyalgia patients report "poor circulation" or numbness and tingling which is not in a radicular pattern and typically involves arms and hands. However, a physical examination reveals normal muscle strength and sensory testing, with no inflammatory or arthritic features.
  2. Stiffness
    Stiffness is also a reported by many fibromyalgia patients and is generally widespread and diffuse. As in other rheumatic diseases, the stiffness is typically worse in the morning, may improve as the day progresses, but is exacerbated the day after physical exertion or exercise. Unlike some rheumatic diseases, however, the pain seldom limits one's ability to get out of bed 3.
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  1. Fatigue
    Fatigue is often the problem that the fibromyalgia patient first describes to the physician. It may be interpreted as a lack of physical endurance or a dearth of psychic energy or initiation 4. The patient may experience short periods of energy (such as for 24 to 48 hours), only to rebound into feeling fatigued and tired again. While this symptom is common, it is not universal.
  2. Non-restorative sleep
    Fibromyalgia patients typically wake up in the morning feeling tired. While this symptom is rarely offered as a complaint by the patient, it is often readily acknowledged upon questioning (e.g. "Do you feel refreshed upon awakening?"). Again, while this symptom is common, it is not universal.

For fibromyalgia treatment see:

Modulating factors of fibromyalgia
All of these symptoms are further highlighted by typical modulating factors. Fibromyalgia patients generally note exacerbation with some or all of the following factors:

  • Cold, damp weather
  • Stress
  • Overexertion

The reverse is also true – patients feel better with warm weather, hot baths, or even vacations from home or work. Almost all patients have tried a variety of non-steroidal anti-inflammatory medications (NSAIDs), but without benefit.

In a study of 50 matched controls, certain associated conditions were found to be unusually common for fibromyalgia patients. This study showed that a relatively high percent of fibromyalgia patients also had:

  • Anxiety disorders – 70%
  • Irritable bowel syndrome (IBS) – 34%
  • Migraine headaches – 22%

Additionally, Raynaud’s syndrome, dysmenorrhea and irritable bladder were common findings 16.

For referenced material, see References

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Thomas Van Sistine
Article written by: Thomas K. Van Sistine, MD