- Fibromyalgia Overview Slideshow
- Take the Fibromyalgia Quiz
- Fibromyalgia: 12 Tips for Coping Slideshow
- Fibromyalgia FAQs
- Patient Comments: Fibromyalgia - Symptoms
- Patient Comments: Fibromyalgia - Treatment
- Patient Comments: Fibromyalgia - Diet and Lifestyle Changes
- Find a local Rheumatologist in your town
- Fibromyalgia facts
- What is fibromyalgia?
- What causes fibromyalgia?
- Is fibromyalgia hereditary?
- What are risk factors for fibromyalgia?
- What are fibromyalgia symptoms and signs? What are fibromyalgia tender points?
- How do physicians diagnose fibromyalgia?
- What specialties of doctors treat fibromyalgia?
- What is the treatment for fibromyalgia?
- Are there any home remedies for fibromyalgia?
- What is the prognosis of fibromyalgia?
- Is it possible to prevent fibromyalgia?
- Are there support groups for fibromyalgia?
- What is the latest research on fibromyalgia?
Quick GuideFibromyalgia Symptoms, Diagnosis & Treatment
What are fibromyalgia symptoms and signs? What are fibromyalgia tender points?
The defining feature of fibromyalgia is chronic widespread pain and tenderness. This means pain in multiple areas of the body, most commonly in muscles, tendons, and joints. Joint stiffness is common, as well. The pain is generally above and below the waist, on the left side of the body and on the right side of the body but can be localized, often in the neck and shoulders or low back, initially. The pain is chronic, which means it is present for more than three months. Patients commonly feel as if they "hurt all over" or as if they have the flu, or are about to develop a cold or the flu. It is common for some days to be worse than others, and many patients report "flare-ups" where their pain and other symptoms are worse for several days in a row or longer.
Fatigue is the other universal symptom of fibromyalgia. It is most noticeable upon awakening, but it may also be marked in the mid-afternoon. It is very common to wake up in the morning not feeling refreshed, even after sleeping through the night. Patients commonly feel they sleep "lightly" and may have multiple nighttime awakenings with difficulty returning to sleep.
While widespread pain, fatigue, and sleep disturbances are the defining symptoms of the syndrome, fibromyalgia is associated with many other symptoms. Disordered thinking (cognitive disturbances) is often referred to as "fibro fog." Patients describe difficulty with attention and completing tasks, as well as a general sense of being in a fog.
Depression and anxiety are present in 30%-50% of patients at the time of diagnosis with fibromyalgia. Headaches are present in more than half of patients. Patients also may have a variety of poorly understood additional symptoms, including abdominal pain, diarrhea, constipation, nausea, dry eyes, dry mouth, chest wall pain, pelvic pain, and bladder symptoms, heart palpitations, numbness and tingling (pins and needles), multiple allergies and chemical sensitivities, weight gain, and others.
Fibromyalgia tender points
The physical examination is remarkable for tenderness, particularly in specific anatomic locations, such as the back of the neck where the neck muscles connect to the skull. There are 18 such locations, which are referred to as fibromyalgia tender points. In the past, studies required patients to have 11 out of a possible 18 fibromyalgia tender points in order to be included in a scientific study on fibromyalgia, but this definition of fibromyalgia has changed in the past few years.