Each patient with fibromyalgia is unique. So a discussion of the fibromyalgia symptom profile must first introduce the reality that there is a wide array of combinations of symptoms that result in the diagnosis of fibromyalgia. The fibromyalgia symptom profile is a different combination of symptoms present among the sufferers of this condition. Any of the symptoms discussed here can occur intermittently and in different combinations.
The most common fibromyalgia symptom is diffuse pain with achiness, stiffness, and extreme tenderness in muscles and/or points where ligaments attach muscles to bones. Although pain may occur widely in many areas of the body, specific sites of tenderness referred to as “tender points” typically occur. These “tender points” can occur around the neck, shoulders, upper back, lower back, hip and knee areas.
This universal symptom of fibromyalgia of pain is not caused by tissue inflammation. Instead, these patients seem to have an increased sensitivity to many different sensory stimuli and an unusually low pain threshold. Minor sensory stimuli that ordinarily would not cause pain in healthy individuals can cause disabling, sometimes severe pain in patients with fibromyalgia. The body pain of fibromyalgia can be aggravated by noise, weather change, and emotional stress.
The pain as reflected as this fibromyalgia symptom profile is generally widespread, involving both sides of the body. Pain usually affects the neck, buttocks, shoulders, arms, the upper back, and the chest. “Tender points” are localized tender areas of the body that can bring on widespread pain and muscle spasm when touched. Fibromyalgia tender points, or pressure points, are commonly found around the elbows, shoulders, knees, hips, back of the head, and the sides of the breastbone.
Fibromyalgia “tender points” are sometimes incorrectly referred to as “trigger points,” which is terminology that is used to describe a situation whereby pressing on certain trigger points can initiate a sequence of symptoms. This is not the case with fibromyalgia tender points, which are chronically a focus of pain and tenderness in the particular area involved.
Another very common fibromyalgia symptom is fatigue, characterized by a lack of endurance or an overall lack of energy. This fatigue occurs in 90% of patients. Fatigue may be related to abnormal sleep patterns commonly observed in these patients. Normally, there are several levels of depth of sleep. Getting enough of the deeper levels of sleep may be more important in refreshing a person than the total number of hours of sleep. Patients with fibromyalgia seem to lack the deep, restorative level of sleep, called “non-rapid-eye-movement” (non-REM) sleep. Consequently, patients with fibromyalgia often awaken in the morning without feeling fully rested. Some patients awaken with muscle aches or a sensation of muscle fatigue as if they had been “working out” all night!
Brain fog is another description of the symptom of fatigue, and some with this fibromyalgia symptom may range from mild to fully incapacitating. This form of fatigue isn’t the same as the general muscle fatigue, and has been described as “brain fatigue”—patients feel totally drained of energy. Many patients say that they feel as though their arms and legs are tied to concrete blocks, and they have difficulty concentrating (i.e., brain fog).
Mental and/or emotional disturbances occur in over half of people with fibromyalgia. These symptoms include poor concentration, forgetfulness, mood changes, irritability, depression, and anxiety. Since a firm diagnosis of fibromyalgia is difficult, and no confirmatory laboratory tests are available, patients with fibromyalgia are often misdiagnosed as having depression as their primary underlying problem. As you can see, the fibromyalgia symptom profile is complicated by the fact that many of the underlying problems in fibromyalgia, such as lack of the restorative value of sleep, will then trigger other symptoms. It ends up being a condition that propagates a cycle of symptoms that will tend to reinforce one another.
Other symptoms related to fibromyalgia may include: sleep disturbance; coldness in hands or feet along with discoloration of skin (bluish or reddish) associated with poor blood circulation (Raynaud’s phenomenon); migraine and tension headaches (experiences in roughly 70% of fibromyalgia patients); abdominal bloating with alternating diarrhea and constipation (irritable bowel syndrome, which is found in 40 to 70% of patients with fibromyalgia); Gastrointestinal Esophageal Reflux Disease (GERD) that includes heartburn, chest pain, regurgitation, indigestion, and chronic cough; temporomandibular joint dysfunction (TMD) is seen in 25% of the fibromyalgia patients, although close to 75% of patients experience some degree of jaw discomfort; muscle tremors; irritable bladder, causing painful and frequent urination; and blurred vision. Emotional stress, anxiety, fatigue, and cold or humid weather may aggravate symptoms.
As you can see, the fibromyalgia symptom profile is very diverse. Several of the symptoms we’ve listed actually tend to cause other related symptoms. If you find that you have one or more of these symptoms on an ongoing basis, it is critical that you consult your health care professional for an assessment and accurate diagnosis.
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