Fibromyalgia Signs and Symptoms

How is fibromyalgia diagnosed? There are specific symptoms of fibromyalgia that set it apart from other disease processes. Fibromyalgia affects all four quadrants of the body equally. In other words, tender points are found on both sides of the upper body (above the waist) and both sides of the lower body (below the waist). The pain at the tender points persists for a period of at least three months.

According to the Academy of Rheumatology (ACR) criteria set approximately one decade ago, tender points are assessed by applying 4 kg/cm² of pressure to specific points on the body. This would be enough pressure to make the examiners fingernail blanch (or turn pale) when pressure is applied. The patient may experience other "tender points," but it is generally felt that these specific model sites are more exquisitely tender to the fibromyalgia patient. Unlike the pain from a "trigger point(s)" found in the taut bands of muscle fiber in chronic myofascial pain, the pain from pressure on fibromyalgia tender points does not radiate to other parts of the body. The lumps and bumps of knotted muscle fiber (trigger points) in chronic myofascial pain do not exist at fibromyalgia tender point sites. Careful examination technique should be used. The physical exam can perpetuate a flare in the fibromyalgia patient causing undue physical stress. If the practitioner finds eleven of the eighteen tender points identified by the ACR model and they fit the pattern previously described, the patient is diagnosed with fibromyalgia. It is important for me to add, current literature suggests many patients may have more or less tender spots, or have tender places in other areas than those noted the in the ACR model. The model should only be used as a guide.

One word I use to describe the symptoms of fibromyalgia is UNPREDICTABLE. They may vary from person to person, day to day, and/or minute to minute and they fluctuate in severity. Identifying the triggers of fibromyalgia symptoms is essential in learning how to keep the occurrences of a flare more manageable.

Common symptoms:

• Pain (often severe and disabling)
• Widespread body aches and soreness
• Morning stiffness
• Tender Points
• Non-restorative sleep (even when 8 hours of sleep is achieved)
• Malaise - Lack of zest or energy

Other symptoms that may accompany FM:

• Anxiety and/or depression
• Bladder difficulties (pain, urinary frequency and/or urgency, burning and or difficulty urinating)
• Bowel habits, altered (irritable bowel syndrome, diarrhea, constipation, painful cramping, bloating, gas, and other related symptoms)
• Chemical sensitivity
• Chest wall pain
• Cognitive disturbances (inability to remember or stay focused, often referred to as BRAIN FOG or FIBROFOG, short-term memory problems)
• Cold intolerance (feeling cold when others are not)
• Dizziness
• Dry eyes and mouth
• Gynecological disturbances or premenstrual syndrome (PMS)
• Headaches, severe & chronic, including migraine
• Impaired coordination
• Irritability or mood changes
• Jaw pain
• Paresthesias, unexplained (numbness or tingling particularly in the arms or legs)
• Photophobia (sensitivity to light)
• Raynaud's syndrome
• Restless leg syndrome (RLS) and/or periodic limb movement (PLM)
• Ringing in the ears
• Sensitivity to odors
• Sensitivity to noise
• Skin - sensitivities, mottling and rashes
• Subjective swelling (a feeling of being swollen but not observed by the examiner)
• Visual problems