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Fibromyalgia Symptoms Definitions


Pain is the most prominent symptom of fibromyalgia. Originally it was thought to be a disease of the muscles and tissues because that's where the pain is usually felt most. In fact, that's how it got its name. "Fibro" refers to fibrous tissues and "myalgia" means pain, so the name fibromyalgia literally means "pain in fibrous tissues."

However, research for the past few years has begun to reveal that, although pain may be felt in the muscles, the problem actually originates in the central nervous system (CNS). There is a malfunction in the CNS, which causes abnormal pain processing. The result is pain amplification.

Something that would cause little to no pain in a healthy person can be extremely painful to someone with fibromyalgia. For example, what feels like a nice firm handshake to the average person can make the person with FM feel as if their hand is being crushed.

The pain of FM is chronic and widespread. It affects all four quadrants of the body (right and left sides, above and below waist), although not necessarily all at the same time. Its intensity may range from mild to profound. FM pain tends to migrate, sometimes affecting one part of the body and sometimes another. Patients also report that their bodies ache all over, much like having the flu.

In addition to the aching, FM pain has been described by different people as burning, throbbing, sharp, stabbing or shooting pain. Most people with FM also complain of feeling stiff and achy when they first get up in the morning.

Fibromyalgia Pain

Cold/Heat Intolerance

Most people with fibromyalgia report being extremely sensitive to cold and/or heat. As with most FM symptoms, this seems to be related to the general state of hypersensitivity that occurs with fibromyalgia.

There may, however, be another explanation that is important to check out. It's not unusual for people with fibromyalgia to also have hypothyroidism. Since the thyroid gland regulates body temperature, any thyroid abnormality could affect how the body responds to external temperature variations.

It's important that FM patients have their thyroid levels checked regularly. Standards of what is considered to be "normal" thyroid levels have changed recently, but not all doctors and labs have caught up with the changes yet. Many FM patients who fell within the normal range under the old standard, but are now being treated for hypothyroidism under the new standards, have experienced a significant improvement in their symptoms.

Depression & Anxiety

Depression, anxiety, irritability, mood swings, personality changes and panic attacks are all symptoms that may accompany fibromyalgia. They do not cause FM; in fact, they are more likely to be the result of it. According to Dr.Robert Bennett, a reknowned FM expert and researcher, the number of fibromyalgia patients who experience depression is no greater than for any other chronic illness.

Despite multiple studies proving fibromyalgia to be a very real physical illness, some patients still have to cope with healthcare professionals who persist in thinking it is primarily a psychiatric problem. However, the tide is turning. With the FDA approval of two medications to treat FM, more and more healthcare professionals are taking it seriously and learning how to treat it.

If you have symptoms of depression, anxiety, or any of the other mood disorders mentioned, be sure to talk with your doctor about it. Left untreated, these symptoms can actually exacerbate many of your other symptoms (e.g., Anxiety causes stress; stress contributes to pain, insomnia, increased fatigue, digestive problems, etc.) and seriously interfere with your quality of life.

Headaches & Migraines

Many people with fibromyalgia say they also suffer from frequent headaches and/or migraines. It's important to note that headaches and migraines are two very different things. A migraine is not just a really bad headache. It is a genetic neurological disease that is characterized by flare-ups, which are called migraine attacks. While head pain is common with migraines, it is possible to have a migraine attack without having a headache.

Like FM, migraine disease seems to be a central nervous system problem that results in hypersensitivity to various triggers. There are many theories as to exactly what happens to bring on a migraine attack, but the most prevalent theory is that people with migraines have overly excitable neurons in their brains. When they encounter a trigger, those neurons fire in a wave across the brain, starting a cascade of events involving several parts of the brain.

Fibromyalgia Headaches and Migraines
The most common type of headache is the tension-type headache. These headaches usually occur on both sides of the head and have a pressing or tightening quality to them. Some patients describe them as feeling like they have a tight band around their head. Since pain in general tends to cause the body to become tense, it's not surprising that people with fibromyalgia might develop tension-type headaches.

One type of headache that is important to mention, especially for FM patients, is the rebound or medication-overuse headache. It is caused by the very medication being taken to relieve the pain. Unfortunately, people who are susceptible to rebound headaches find themselves in a catch-22 situation.

In these cases, when patients take medication to relieve the headache or migraine pain more than two or three times a week, their bodies get used to having the medication and actually create a headache in order to get more of the medication. The only way to break this cycle is to stop taking the medication that caused it. This can be a particularly difficult problem for people with fibromyalgia since often the medications being taken to relieve FM pain can cause rebound headaches.

  Fibromyalgia Cognitive Function

Cognitive Function

Most fibromyalgia patients report having problems with memory and cognitive functioning. The cognitive functioning difficulties FM patients must cope with include:
  • Short-term memory loss
  • Difficulty with concentration
  • Inability to retain what is read
  • Word-finding difficulty
  • Inability to calculate numbers
  • Slowed comprehension
  • Impaired speech
  • Inability to keep track of things
  • Problems with reasoning
Fibromyalgia patients have coined the term "fibro fog" to describe their cognitive functioning problems. It's an accurate description because it feels as if your brain is in a thick fog, unable to "see" its surroundings.


Fibromyalgia specialists agree that getting a good night's sleep is essential and most say inadequate sleep is the first symptom they treat. Many of the FM symptoms - body aches and pains, fatigue, headaches, depression, irritability, digestive problems - are also the classic symptoms of sleep deprivation. That's not to say fibromyalgia is simply a sleep disorder; there's much more to it than that. But it's clear that unrefreshing sleep does make the symptoms worse. Conversely, correcting the sleep problems will usually result in symptom improvement.

Your doctor may ask you to have a sleep study done to determine whether you have sleep apnea. If you do, using a CPAP (Continuous Positive Air Pressure) machine when you sleep may be all you need. If you don't have sleep apnea, your doctor may give you a prescription for an antidepressant (which can help improve sleep), or a medication specifically designed as a sleep aid. If you would rather not take prescription drugs, talk to your doctor about taking an herbal supplement like melatonin, valerian root or GABA. In addition to medications or supplements , it's important for you to develop good sleep habits.

Digestion & IBS

Digestive problems and irritable bowel (IBS) frequently accompany fibromyalgia. Abdominal pain, bloating, and discomfort are the main symptoms of IBS. Some people also experience constipation; others have chronic diarrhea; and some alternate between constipation and diarrhea.

Fibromyalgia Digestion
Researchers have not yet discovered a specific cause for IBS. Below are some of the possibilities that might explain its relationship to FM:

• One theory is that people who suffer from IBS have a colon, or large intestine, that is particularly sensitive and reactive to certain foods and stress. Since FM tends to involve general hypersensitivity, it follows that they could have a sensitive digestive tract. Food related research has been a fast growing topic for Fibromyalgia research, and in May 2012 an interesting article on food hypersensitivity was published.

• Normal motility, or movement, may not be present in the colon of a person who has IBS. Staying active and exercising regularly can help the colon maintain its natural motility, but people with FM tend to be less active and often shy away from exercise because of the pain.

• According to the National Institutes of Health, "Recent research has reported that serotonin is linked with normal gastrointestinal (GI) functioning. Serotonin is a neurotransmitter, or chemical, that delivers messages from one part of your body to another. Ninety-five percent of the serotonin in your body is located in the GI tract, and the other 5 percent is found in the brain. Cells that line the inside of the bowel work as transporters and carry the serotonin out of the GI tract. People with IBS, however, have diminished receptor activity, causing abnormal levels of serotonin to exist in the GI tract. As a result, they experience problems with bowel movement, motility, and sensation - having more sensitive pain receptors in their GI tract." Since people with FM are known to have lower than normal levels of serotonin, this could be a significant factor.

Restless Legs Syndrome

Approximately 30 percent of people with fibromyalgia also have restless leg syndrome (RLS). RLS is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest. People describe these unpleasant sensations as burning, creeping, tugging, or like insects crawling inside the legs. The sensations may range in severity from uncomfortable to irritating to painful.

The most distinctive feature of RLS is that lying down and trying to relax actually activates the symptoms, which can significantly interfere with sleep. Because moving the legs relieves the discomfort, people with RLS often keep their legs in motion. They toss and turn in bed and often find they have to get up and walk to relieve the sensations.

More than 80 percent of people with RLS also experience a more common condition known as periodic limb movement disorder (PLMD), which is characterized by involuntary twitching or jerking of the legs during sleep. These movements typically occur every 10 to 60 seconds and may continue throughout the night, causing repeated awakening and severely disrupting sleep.

The cause of both RLS and PLMD remains a mystery. Both, however, result in poor sleep quality, leaving patients with exhaustion, poor concentration, and an inability to accomplish normal daily tasks.

Energy & Fatigue

The fatigue experienced by fibromyalgia patients is nothing like the fatigue most people experience at the end of a long day or following a strenuous workout. It is a pervasive, all-encompassing exhaustion that can interfere with even the most basic and simple daily activities. For example, FM patients frequently say that by the time they shower and get dressed to go out, they are too tired to go anywhere.

Another defining factor of the fatigue of fibromyalgia is that it is not relieved by sleep. Patients may awaken feeling just as fatigued as they did before they went to sleep. Because getting good, deep, refreshing sleep is essential for the body to replenish itself, healthcare professionals will often address sleep issues first. If sleep problems can be corrected, fatigue symptoms should begin to improve as well.

See symptoms overview and checklist »
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