Fibromyalgia - Symptoms

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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.

Return to Fibromyalgia

See what others are saying

Comment from: Kmac, 35-44 Female (Patient) Published: October 06

I thought I had a reoccurring ear infection, with severe pain in my ear and on the left side of my face. That lasted for a couple of years on and off and while pregnant, I thought that I had been introduced to pregnancy arthritis. After the birth of my baby it did not go away, it seems that it only get worse. And so my initial thought was that I had rheumatoid arthritis, or some type of arthritis. The pain in all of my joints and the skin on the back of my neck, my ear, and in the side of my face was pretty substantial. We saw many doctors, and had many emergency room visits for ear infections, without finding anything. Finally one night in the emergency room the doctor looked at me and said this is not an ear infection, and that I have a small case of fibromyalgia and I had never heard of it before then.

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Comment from: RoyalGeek, 25-34 Female (Patient) Published: April 11

After going from doctor to doctor, finally a neurologist suggested that I have fibromyalgia. My numerous blood tests were all good. CAT of my head was fine, MRI of my jaw and neck were fine, and x-ray of my chest was fine. I have chronic headaches and migraines, pain in my knees and elbows, collarbones and neck, hips, thighs, pelvis, jaw, even my underarms and sides of my breasts. I am always so tired and gained a bunch of weight. But according to my family doctor and others, I am fine. It is frustrating. I also have bad anxiety and am afraid I have something bad that the doctors might have missed. I'm tired of being in pain and refuse to take any pain medicines since my family has a history of addiction.

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