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When Fibromyalgia Is More than Pain

By Celeste Cooper

The body-wide pain of fibromyalgia is usually the symptom that leads us to seek medical advice. Other complaints such as non-restorative sleep, fatigue, and thought processing difficulties have also become predominant diagnostic criteria.

However, other symptoms do cluster with what Dr. Frederick Wolfe calls “fibromyalgianess” (1), a label that is often interpreted as “these symptoms are all in your head.” This poly-symptomatology is mentioned in the American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia. (2) Interestingly, the ACR assured me in writing that they did not — and will not —  approve any diagnostic criteria, preliminary or otherwise. I am equally appalled when lead investigator Dr. Frederick Wolfe says, “There is a lot invested in what I would call a psycho-cultural illness.” (3)

Following is the list of what Dr. Wolfe calls poly-somatic complaints. I have categorized them by disorders that have been recognized to occur with FM by various health organizations such as the American College of Rheumatology, the Centers for Disease Control, and The National Institutes of Health. It ONLY includes symptoms included or alluded to in the Wolfe criteria. It is not complete and not meant to be a self-diagnostic tool.

Irritable bowel syndrome

Temporomandibular Dysfunction (TMD/TMJ)

Thyroid problems

Myofascial Pain Syndrome

Painful Bladder Syndrome (Interstitial Cystitis)

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

Headache, severe


Rheumatic disorders

If your symptoms are bothersome or ignored because your physician aligns with the opinions of Dr. Wolfe, they need to be investigated. A secondary condition that is properly diagnosed and treated will improve your overall outcome.

I am a proponent of the research and alternate criteria (4) led by Dr. Robert Bennett, who has been kind enough to answer questions here on ProHealth [1].


  1. Frederick Wolfe. Fibromyalgianess. Arthritis Rheum [2]. 2009 Jun 15;61(6):715-6.
  2. Wolfe F, Clauw DJ, Fitzcharles MA, et al. The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity. Arthritis Care Res [3] (Hoboken). 2010 May;62(5):600-10
  3. News Medical Life Sciences & Medicine. March 22, 2013. Fibromyalgia: an interview with Dr Frederick Wolfe, University of Kansas School of Medicine. http://www.news-medical.net/news/20130322/Fibromyalgia-an-interview-with-Dr-Frederick-Wolfe-University-of-Kansas-School-of-Medicine [4].aspx
  4. Bennett R, Friend R, Marcus D, et al. Criteria for the diagnosis of fibromyalgia: Validation of the modified 2010 preliminary ACR criteria and the development of alternative criteria. Arthritis Care Res [5] (Hoboken). 2014 Sep;66(9):1364-73.

Celeste Cooper, RN, is an advocate, writer and published author, and she is a person living with chronic pain. She is lead author of Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain and Broken Body, Wounded Spirit, Balancing the See Saw of Chronic Pain (a four book series). She spends her time enjoying her family and the rewards she receives from interacting with nature through her writing and photography. You can learn more about Celeste’s writing, advocacy work, helpful tips, and social network connections at http://CelesteCooper.com [6].