Two or more symptoms are typically present in individuals by the time they seek medical attention. However, it would be rather unusual for an individual to have all the symptoms and signs listed. Click here for the PDF version of this table: Signs and symptoms of fibromyalgia.
Pain, the Prominent Symptom
Pain is the main symptom of fibromyalgia, and it must have been present for at least three months to be considered a diagnostic element of this condition. The pain is often localized to a specific point, sometimes intermittent, and sometimes increasingly persistent.
Although this pain is felt in the muscles and joints, there are no physical abnormalities in the painful tissues. The involvement of a neuropathic pain mechanism is suspected, as patients often describe the pain as a burning or stabbing sensation. The site and intensity of the pain can vary from day to day and can be influenced by factors such as stress and temperature. In fact, symptoms are sometimes aggravated in cold and humid temperatures.
In addition to pain, other common symptoms in people with fibromyalgia can account for 30% of their suffering. The state of hyperexcitability of the central nervous system explains in part their increased sensitivity to touch, smells, noises, temperature changes, etc.
Fatigue
Fatigue, reported by more than 90% of people with fibromyalgia, is the most common accompanying symptom. For some people, fatigue can be even more disabling than pain.
This fatigue is unusual and persistent and is often accompanied by a lack of physical and mental stamina. The person always feels a sense of heaviness. A similar type of fatigue has been observed in chronic fatigue syndrome, but in people with FM, pain is predominant.
Sleep Disorders
Non-restorative sleep is associated with fibromyalgia. Among the various sleep disorders measured are sleep onset latency, sleep disturbances, and fragmented sleep. These factors lead to a deterioration in day time functioning.
Poor sleep quality affects fatigue, mood, and pain. These can all be improved with targeted sleep management. Other sleep disturbances, such as restless leg syndrome and sleep apnea, are also common in patients with FM.
Neurocognitive Dysfunction
Neurocognitive dysfunction or “brain fog” is characterized by difficulty concentrating, memory lapses, short-term memory loss leading to slower processing speed, lack of verbal fluency, slower movements, inability to multitask, distractibility and/or cognitive overload, and disorientation.
Brain fog is not dementia or early-onset Alzheimer’s disease. The person’s learning and memory abilities remain normal, but information processing slows down due to fibromyalgia.
Mood Disorders
Mood disorders including depression, anxiety, bipolar disorder, and dysthymia, affect 75% of people with fibromyalgia. However, these mood disorders are distinct from FM.
Anxiety is generally associated with depression, but we see an increased presence of independent anxiety in people with FM. Symptoms include excessive anxiety, exaggerated fears, worry, avoidance, and compulsive behaviours. Catastrophism and pessimism are often present.
Factors influencing depression include a lack of family cohesion, intense pain, feelings of helplessness, and a passive attitude towards adapting to situations. Biological family members of the person with FM or major depressive disorder (MDD) sometimes have similar rates of MDD. These findings suggest that certain risk factors, likely genetic, are common to both conditions.
Other symptoms
Certain studies link other conditions and physical manifestations to fibromyalgia. These include irritable bowel syndrome (IBS), migraines, severe menstrual pain, urinary tract infections, myofascial pain, and temporomandibular joint pain.