Because the classic symptoms of fibromyalgia — widespread muscle and joint pain and fatigue — aren't very distinctive, the condition is often misdiagnosed and misunderstood. You may not have all of the symptoms, and you may have other medical problems too.
There are no specific lab or imaging tests to diagnose it, so your doctor will ask about your symptoms to decide if you have fibromyalgia.
What Are the Symptoms of Fibromyalgia?
Those with fibromyalgia may have an unusual sensitivity to pain. It's believed that your body abnormally processes pain if you have fibromyalgia.
There is no complete list of fibromyalgia symptoms. The condition affects people differently. However, many people with fibromyalgia, also called fibromyalgia syndrome (FMS), may have symptoms such as:
- Pain and tender points
- Fatigue
- Sleep problems
- Concentration and memory problems, known as "fibro fog"
- Increased sensitivity to sensory stimulation, such as light, noise, smells, heat and cold
- Anxiety or depression
- Morning stiffness
- Numbness and tingling in hands, arms, feet, and legs
- Burning sensation in hands and feet
- Muscle twitches or cramps
- Face or jaw pain or jaw disorders such as temporomandibular joint syndrome (TMJ)
- Headaches
- Irritable bowel syndrome and other digestive issues
- Sexual issues including poor lubrication and pelvic floor muscle problems
- Urinary problems
- Painful menstrual cramps
What Does Fibromyalgia Feel Like?
Almost all people with fibromyalgia ache all over. It can feel similar to osteoarthritis, bursitis, and tendinitis, but it affects your entire body. This is usually what makes you visit your doctor.
The pain can be deep, sharp, dull, throbbing, or aching. You feel it in your muscles, tendons, and ligaments around the joints. For some people, the pain comes and goes. It could travel throughout your body.
You may also have tender points -- specific spots around your joints that hurt when you press them with a finger. If you press a tender point on a person without fibromyalgia, they'll just feel pressure — but for someone with fibro, that would be very painful.
These tender points are in predictable places on the body. They're often under the surface of the skin, not in areas of deep pain. It's the tissue around the muscles and joints that hurts rather than the joints themselves.
Fibromyalgia Fatigue
Constant fatigue and feeling drained are other main symptoms. People often feel tired even when they should feel rested, such as after a good night's sleep. Some say it's like having the flu. Some compare it to working long hours and missing a lot of sleep.
You may feel too tired to exercise or more tired after a workout. Simple things such as grocery shopping or cooking dinner could wipe you out. Starting a project such as folding clothes or ironing could seem like too much effort. You might even be too tired for sex.
Sleep Problems
The majority of people with fibromyalgia have trouble sleeping. You may be able to fall asleep, but your sleep is light and easily disturbed. When you get up in the morning, you're exhausted and not refreshed. It doesn't help the fatigue.
Tests done in sleep labs show that people with fibromyalgia are constantly interrupted by bursts of brain activity even during sleep, similar to what happens when they're awake. These interruptions limit how much time you spend in deep sleep, during which your body restores itself. As a result, you feel very tired.
Fibro Fog
The term fibro fog refers to the cluster of brain and cognitive-related symptoms of fibromyalgia. The causes of fibro fog are not fully understood; but treating the tiredness, pain, sleep problems, and mental issues linked to fibromyalgia is believed to bring relief.
Fibro fog is a loss of mental sharpness that includes:
- Forgetfulness
- Trouble recalling new information
- Slowed thinking, particularly when distracted
- Lack of alertness
- Loss of attention and focus
- Confusion regarding words or details
- Trouble concentrating
- Losing your train of thoughts
- Problems holding conversations
- Difficulty recalling known words (dysphasia)
- Problems with planning, making decisions, or thinking abstractly
Mood Disorders
About 20% of people with fibromyalgia also have depression or an anxiety disorder.
Dealing with fatigue and pain all the time can be stressful. You probably worry about keeping up with life and what you can do to feel better. You may become less active and more withdrawn, which can lead to depression.
It's also possible that anxiety and depression may actually be a part of fibromyalgia, like the pain.
People diagnosed with fibromyalgia and depression have a hard time with concentration and short-term memory, which makes it hard to remember day-to-day things, such as where they've put their keys or plans they've made for lunch tomorrow.
Morning Stiffness
Most people with fibromyalgia feel like they need to "loosen up" after getting out of bed before they can start their day. The muscles and joints of their back, arms, and legs feel stiff. It's not typical creakiness. It's more like the stiffness someone with rheumatoid arthritis feels.
Although some people say it lasts only a few minutes, the stiffness usually sticks around for more than 15-20 minutes each day. Sometimes it lasts for hours, and it could linger all day.
Swelling and Tingling in Hands and Feet
While the cause of numbness, tingling, and burning is unclear, many people with fibromyalgia feel them. These sensations, called paresthesia, tend to happen randomly. They may last a few minutes, or they may be constant.
The feelings can be especially bothersome in the mornings along with morning stiffness. But they generally don't get in the way of doing things.
Headaches
Some 2 out of 5 people with fibromyalgia also get migraine or tension headaches regularly. They may be a result of pain in your neck and upper back. They're often caused by tight neck muscles. They may also be caused by tender points over the back of your head and neck.
Headaches can make it much harder for you to live with fibromyalgia and manage the disease.
Irritable Bowel Syndrome
About two-thirds of people with fibromyalgia often have belly pain, gas, and bloating and feel like throwing up. They can also have constipation and diarrhea.
Many have acid reflux or gastroesophageal reflux disease (GERD) too.
Reproductive Symptoms
Fibromyalgia symptoms in people assigned female at birth (AFAB) can affect several areas of their reproductive systems. Hormonal changes, such as those during your menstrual cycle, are believed to be one of the triggers for the disorder. Research shows that fluctuations in the corticotropin-releasing hormone (CRH) and other reproductive hormones may play a role in fibromyalgia symptoms. Other studies have found that fibromyalgia is linked to endometriosis and higher incidences of pelvic inflammatory disease and pelvic floor muscular weakness in women and people AFAB.
Fibromyalgia-related hormonal imbalances are linked to:
- Extremely painful periods
- Pelvic pain
- Chronic pain of the vulva (vulvodynia)
- Early-onset menopause
Rare Fibromyalgia Symptoms
While widespread pain and fatigue are the most commonly known features of fibromyalgia, other less common symptoms can also show up with the condition. These include:
- Sensitive skin and rashes
- Dry mouth and eyes
- Ringing in the ears (tinnitus)
- Vision issues
- Coordination issues
- Restless legs syndrome
- Raynaud's syndrome (cold and numb feet and hands in response to cold temperatures)
When to See a Doctor About Fibromyalgia Symptoms
See your doctor if you have new and unexplained pain, tiredness, or brain fog as well as depression or other mental health issues. Your regular doctor may refer you to a rheumatologist, a medical specialist who diagnoses and treats diseases affecting the muscles, joints, and bones, including fibromyalgia. The rheumatologist may in turn refer you to a pain specialist if you're dealing with chronic pain.
There's no single test that can tell your doctor you have fibromyalgia. Rather, they rule out other conditions first. At your visit, you should tell your doctor how your symptoms impact your daily life. Because fibromyalgia symptoms mimic those of other conditions, it's important to tell your doctor clearly when you feel pain and where, what triggers it, and how long it lasts, along with any other symptoms. Also, tell your doctor if your symptoms make you anxious or depressed or keep you from sleeping.
When you see your doctor, it's helpful to ask the following questions:
- What tests confirm or rule out fibromyalgia?
- What treatments are available if I'm diagnosed with it?
- What other types of health care professionals do I need to see?
- How often should I see you or other medical providers?
Takeaways
Fibromyalgia appears as pain in all areas of your body. It's also marked by fatigue, sleep disruption, and cognitive issues collectively known as "fibro fog." Although researchers aren't sure what specifically causes fibromyalgia; it's thought that the people who experience it have an unusually high pain sensitivity. There's no cure for fibromyalgia, but your symptoms can be eased with over-the-counter and prescription medicines, as well as by exercise, relaxation, and relieving stress.
Fibromyalgia Symptoms FAQs
How do I know if I have fibromyalgia?
Fibromyalgia is tough to diagnose. What are usually the first signs of fibromyalgia? If you are consistently tired, have widespread body pain, sleep and gastrointestinal issues, and difficulty thinking clearly, you should see your doctor. They can confirm or rule out fibromyalgia.
Who typically gets fibromyalgia?
Those over 40, women and people AFAB, as well as people with certain chronic illnesses such as arthritis, depression, anxiety, or irritable bowel syndrome (IBS) are more likely to develop fibromyalgia. If you have recently had an infection, experienced trauma, or are under a lot of stress, you may also be at risk for fibromyalgia.
What is the average age for fibromyalgia?
Fibromyalgia can affect people of any age, but it typically affects those in middle age, usually between the ages of 35 and 45.
What worsens fibromyalgia pain?
Stress, exertion, hormones, poor sleep, and even weather changes can worsen your fibromyalgia pain.
