What is fibromyalgia?

Fibromyalgia is a chronic disorder and symptoms can wax and wane for long periods of time.

As with many other pain disorders, the symptoms of fibromyalgia vary from person to person. Symptoms can also differ in severity from day to day. And they may vary based on certain factors, like stress level and diet.

The main symptom of fibromyalgia is pain in the muscles, joints, and tendons. This pain can be widespread throughout the body. Many people describe it as a deep, dull ache within the muscles that gets worse with strenuous exercise.

The pain can also be throbbing, shooting, or burning. And it may radiate from areas of the body known as tender points, and can be accompanied by numbness or tingling in the limbs.

Pain is often worse in frequently used muscles like those in the hands, feet, and legs. Stiffness in these joints is also common.

Although not the case for all people with fibromyalgia, some report that the pain is more severe upon waking, improves during the day, and gets worse in the evening.

Tender points are spots on the body that become very painful even when only a small amount of pressure is applied. A doctor will often touch these areas lightly during a physical exam. Pressure on a tender point may also cause pain in areas of the body far away from the tender point.

There are nine pairs of tender points that are often associated with fibromyalgia:

  • both sides of the back of the head
  • both sides of the neck
  • top of each shoulder
  • shoulder blades
  • both sides of the upper chest
  • outside of each elbow
  • both sides of the hips
  • buttocks
  • insides of the knees

The first diagnostic criteria for fibromyalgia, established by the American College of Rheumatology (ARC) in 1990, stated that there needed to be pain in at least 11 of these 18 points in order to make a fibromyalgia diagnosis.

Although the tender points are still considered to be important, their use in the diagnosis of fibromyalgia has decreased. In May 2010, the ACR developed new criteria, acknowledging that the diagnosis of fibromyalgia should not be based only on tender points or the severity of the pain symptoms. It should also be based on other constitutional symptoms.

Extreme fatigue and exhaustion are common symptoms of fibromyalgia. Some people also experience “fibro fog,” a condition that may include difficulty concentrating, remembering information, or following conversations. Fibro fog and fatigue can make work and everyday activities difficult.

People with fibromyalgia often have difficulty getting to sleep, staying asleep, or reaching the deepest and most beneficial stages of sleep. This can be due to pain that wakes people repeatedly throughout the night.

A sleep disorder like sleep apnea or restless leg syndrome could also be to blame. Both of these conditions are associated with fibromyalgia.

Psychological symptoms are common since fibromyalgia may be related to imbalances in brain chemistry. These symptoms can also be caused by abnormal levels of certain neurotransmitters and even from stress from coping with the disorder.

Psychological symptoms include:

  • depression
  • anxiety
  • post-traumatic stress disorder (PTSD)

People often use support groups to get help with these symptoms.

There are several other conditions that are more common among people with fibromyalgia than in the general population. Having these other conditions only increases the number of symptoms someone with fibromyalgia may have. These include:

  • tension and migraine headaches
  • irritable bowel syndrome
  • restless legs syndrome
  • chronic fatigue syndrome
  • lupus
  • rheumatoid arthritis