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Most Common Signs of Fibromyalgia

10 min read

By Emily Lockhart

Medically Reviewed by Dr. Gerald Morris

Causing widespread pain to an estimated 4 million people in the United States, fibromyalgia is a musculoskeletal disorder that amplifies the way the brain processes pain, often leaving the body’s pain receptors in hyperdrive.

The condition causes widespread pain—and in turn fatigue, sleep deprivation, and depression—and typically begins following some type of severe physical trauma, such as an accident, surgery, or massive psychological stress.

Fibromyalgia patients complain of a myriad of symptoms associated with pain throughout the entire body. Here are the 20 most common symptoms of fibromyalgia…

1. Pain

Pain is the definitive symptom of fibromyalgia, but it can present itself in different ways and in different parts of the body. Some people complain of constant stabbing pain throughout their entire body, while others experience a duller form of continuous aching. Alternately, fibromyalgia pain can be localized to one or more areas of the body, or it can seem to cluster around multiple “pain centers.”

One of the most vexing things about fibromyalgia is that the pain it causes has no apparent cause. Yet, some patients say that they do experience some identifiable pain triggers. First, changing weather conditions (e.g., rising pressure, falling pressure, and changes in humidity) can make the pain more intense or “wake the pain up” after a latent period. Others experience a sharp increase in their fibromyalgia pain if they are dealing with professionally or emotionally stressful situations, suggesting that the pain may have a strong psychological component.

2. Sensitivity to Touch

There are two medical terms that cover the increased sensitivity to touch that most fibromyalgia patients experience: hyperesthesia and hyperalgesia. Hyperesthesia describes an increased sensitivity to the sensory input of touch; for example, being under a light blanket may make you feel as though you’re trapped under a heavy lead weight. Hyperalgesia, on the other hand, describes an increase in pain sensation; for instance, you might stub your toe on a table leg, only to feel excruciating and throbbing pain for hours or days afterwards.

In extreme cases, both hyperesthesia and hyperalgesia may become so pronounced and severe that the patient is functionally unable to participate in routine activities. Some fibromyalgia patients describe a sort of cycle associated with these symptoms. Sensitivity will flare up and symptoms will worsen, then it will alleviate and the patient will be able to return to their normal activities…until the cycle starts all over again.

3. Environmental Sensitivity

People with fibromyalgia typically experience sensory abnormalities that go beyond sensitivity to touch. They are often strongly affected by environmental influences, even ones that seem minor to most other people. Such symptoms usually involve the patient’s senses of smell, sound, and sight.

For example, a person with fibromyalgia may be extremely sensitive to cigarette smoke, or feel nauseous upon stepping into a freshly painted room. Chemical-based cleaning products also seem to trigger these types of sensitivities to the point where the patient is unable to use them or be in an area where they were recently used. Sounds in a moderate volume range can seem extremely loud and can even cause headaches and other extreme reactions. Lighting levels usually affect the patient’s sense of sight; lights may seem unbearably bright, even when they are at normal levels, and even if the patient is in a familiar environment.

4. Muscle Stiffness

Fibromyalgia can also cause feelings of stiffness in muscles. While it’s normal to experience these types of sensations after periods of strenuous physical activity, people with fibromyalgia develop muscle stiffness for no immediately apparent reason. Like fibromyalgia pain, this stiffness can be generalized throughout the body, or it might affect one or more localized muscle groups.

Some fibromyalgia patients say their muscle stiffness is worse first thing in the morning or after they have been sitting down or motionless for an extended period of time. This, in and of itself, is fairly normal, especially in older people. However, people with fibromyalgia do not experience significant relief after they get up and start moving around again. In fact, in some fibromyalgia cases, movement can worsen rather than relieve muscle stiffness. Over-the-counter medications don’t usually offer sustained relief either.

5. Joint Stiffness

Similar to muscle stiffness, another common symptom of fibromyalgia is stiffness in joints and connective tissues. The patient might notice pain, swelling, and tenderness in certain joints with no reasonable cause. This stiffness may occur in one joint or could be affecting multiple joints throughout the body.

Patients have described fibromyalgia joint pain as burning, aching, stabbing, tingling, throbbing, or even general numbness or loss of feeling. The level of pain may vary depending on the time of day, weather, stress, and activity levels.

6. Muscle Spasms

Minor muscle spasms are something most people experience from time to time. However, fibromyalgia patients tend to experience extreme spasms, even after medical investigations uncover no root physical cause for them. Muscles seem to go into spasms spontaneously; sometimes, one or more specific muscles is affected again and again. In other cases, the patient finds it impossible to predict where the next spasm will strike, since it could happen almost anywhere and at just about any time.

Generally, though, fibromyalgia muscle spasms follow a pattern. They affect one particular muscle group again and again, and the most intense spasms will occur at night. These spasms can be intense enough and painful enough to disrupt sleep. Such spasms also happen with little to no warning, and they can still happen, even if the patient takes extra care to rest and avoid straining the affected muscles or muscle groups.

7. Exhaustion

Chronic fatigue and exhaustion also occur in a large percentage of fibromyalgia patients. Doctors believe it has two root causes. First, the fibromyalgia syndrome itself seems to drain patients of energy, even if they aren’t overexerting themselves physically or mentally. In other words, fatigue and exhaustion are core symptoms of the condition and occur for no other reason.

However, a growing body of researchers believe that the fatigue and exhaustion symptoms may be exacerbated or even caused by sleep disturbances. The pain and muscle spasms caused by fibromyalgia cause most sufferers to lose sleep. Over time, this chronic sleep deprivation can lead to constant feelings of tiredness, which becomes a vicious cycle when the patient tries to sleep and can’t because of the pain. Regardless of the root cause, the chronic fatigue and exhaustion caused by fibromyalgia will eventually take a toll on the immune system, and cause the patient’s energy levels to plummet.

8. Trouble Concentrating

Memory and concentration also seem to be affected by fibromyalgia, although researchers aren’t quite sure whether this is part of the chronic fatigue and exhaustion syndrome of the condition or whether it has different causes altogether. What is known is that the patient’s short-term memory can be noticeably compromised. Patients have a hard time retaining information, recalling newly learned facts and skills, and tend to find it very difficult to sustain concentration for an extended period of time.

Some patients complain of a pervasive feeling of mental sluggishness or cloudiness. This condition has earned its own nickname: “fibro-fog.” The cognitive impairments associated with fibromyalgia are most likely caused by ongoing sleep loss, but some researchers aren’t sure it can be explained away so easily. There is some evidence to suggest that the condition may actually inhibit the brain’s ability to function normally by interfering with its synaptic pathways.

9. Chronic Headaches

Many fibromyalgia patients report experiencing persistent headaches or migraines, which can be very severe and debilitating. Headache pain usually presents as a feeling of constant pressure or throbbing affecting the head. It is also common for headache pain to seem to extend further down the body into the neck, shoulders and even the upper back.

Some people suffering from fibromyalgia claim that their headaches are often triggered by environmental sensitivities. As mentioned earlier, bright lights, strong smells, and loud sounds can all seem far more intense to a fibromyalgia patient. Many times, a patient reports feeling fine until encountering one of these environmental triggers, after which a headache sets in. That headache may not go away for hours or even days, even after the patient moves into a trigger-free environment. In some cases, fibromyalgia headache pain can be strong enough to cause ongoing sleep disturbances.

10. Bowel Troubles

Fibromyalgia can also cause bowel disturbances, putting the patient at risk of developing a condition known as irritable bowel syndrome, or IBS. In fact, fibromyalgia and IBS have very high comorbidity rates, suggesting that there is indeed a definitive link between the two. From a general standpoint, the muscle stiffness and generalized pain caused by fibromyalgia often cause patients difficulty in passing bowel movements. Over time, impacted fecal matter becomes even more difficult to clear, which can lead to reliance on and overuse of laxatives, which itself can cause further complications.

In other instances, patients experience diarrhea rather than constipation or an urge to evacuate the bowels, even when the intestines are empty. As with most other symptoms of this mysterious condition, researchers aren’t quite sure of the root cause. Thus, treatment of bowel disturbances is palliative and aimed at relieving the most pressing symptoms.

11. Depression

From an emotional and psychological standpoint, people with fibromyalgia are at increased risk of developing chronic depression. In all likelihood, this depression results from having to deal with constant pain, loss of sleep, lack of energy, and being forced to give up activities the patient once enjoyed. As with fibromyalgia headaches, researchers aren’t sure whether the proverbial chicken or the proverbial egg comes first; depression may not be the result of a patient’s will wearing down over time, but rather, they could be caused independently through changes in brain chemistry.

For patients, the good news is that fibromyalgia seems to respond well to certain antidepressants. These drugs not only help relieve the symptoms of depression but also seem to calm down the constant pain, muscle stiffness, muscle spasms and other symptoms of the syndrome. Your doctor may prescribe them even if you haven’t developed any symptoms of depression.

12. Trouble Sleeping

Sleep issues and fibromyalgia varies from person to person but is often a common symptom in some form. Many who struggle with fibromyalgia find it challenging to fall asleep at night and struggle with staying asleep once they do. Patients often experience disruptions in sleep and wake up often during the night without cause.

13. Poor Sleep Quality

Similar to trouble sleeping, many patients with fibromyalgia often report that the sleep they do get is often poor and lacks quality. Those with fibromyalgia often wake up feeling unrefreshed and fatigued, even after a full night’s sleep. Research has shown that poor sleep quality often makes pain associated with fibromyalgia worsen.

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13. Memory Problems

Another reported symptom of fibromyalgia is difficulty recalling memories or retaining information. This is often referred to as “fibro fog.” Learning, listening, and retaining information is a commonly reported symptom of fibromyalgia. Patients have reported confusion, often losing a train of thought, or forgetting common words and memories.

14. Cognitive Issues

Similar to memory problems, another reported symptom of fibromyalgia is general cognitive issues which is another aspect of “fibro fog.” Patients typically have difficulty with simple mental tasks and have poor judgment with common issues. Those struggling with cognitive issues due to fibromyalgia might struggle with learning and remembering new things as well as a low concentration span. Another cognitive issue that may arise is trouble speaking or slow, confused speech.

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15. Anxiety

On the mental side of common symptoms, many with fibromyalgia have reported increased levels of anxiety. Anxiety is known to cause hypersensitivity in the body which can often amplify the pain symptoms already apparent with fibromyalgia. It’s also likely that the anxiety can be caused by the fears and worries surrounding the illness, which in turn, can occasionally make fibromyalgia worse.

16. Dizziness

Although less common, another reported symptom of fibromyalgia is struggling with dizziness. Those who have been diagnosed with fibromyalgia often report an overall increased sense of clumsiness and disorientation with the world around them. Dizziness, poor balance, lightheadedness, and falls are all common symptoms of fibromyalgia that can vary in severity from a minor annoyance to severely debilitating.

17. Unsteady Body Temperature

Patients with fibromyalgia have also reported feeling as though they are unable to regulate their body temperature. Those with fibromyalgia have reported either feeling too hot or too cold on a regular basis without the ability to properly regulate their body temperature.

18. Restless Leg Syndrome

Another commonly reported symptom of fibromyalgia is “restless leg syndrome” which is an uncomfortable feeling in the legs and an overall urge to move them often. Restless leg syndrome is most commonly noticed while the patient is stagnant or trying to fall asleep, which often contributes to their poor quality of sleep or trouble falling asleep.

19. Tingling In Hands

Another possible symptom of fibromyalgia is a feeling of tingling in the hands. Patients have described this uncomfortable sensation in the hands as anything from simple tingling to numbness, prickling, or even burning. This feeling is also sometimes described as a sensation of “pins and needles,” also known as paraesthesia.

20. Painful Periods In Women

Another reported symptom of fibromyalgia for women specifically is increased pain during menstruation. Women with fibromyalgia have reported stronger or more painful than usual menstrual cramps as well as amplified typical menstrual symptoms including lower back pain, achiness, and tenderness.

Women with fibromyalgia have also reported worsened mental symptoms including depression or increased mood changes during their period.

MD, Family Medicine, Internal Medicine

Gerald Morris, MD is a family medicine/internal medicine physician with over 20 years expertise in the medical arena. Dr. Morris has spent time as a clinician, clinical research coordinator/manager, medical writer, and instructor. He is a proponent of patient education as a tool in the diagnosis and treatment of acute and chronic medical conditions.

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