Symptoms of Fibromyalgia
Fibromyalgia is characterized by chronic widespread pain affecting all four body quadrants as the dominant symptom, along with fatigue, non-refreshed sleep, mood disturbance, and cognitive impairment. 1
Core Symptoms
Pain Characteristics
- Chronic widespread musculoskeletal pain (present in all four quadrants of the body)
- Pain that persists for at least 3 months
- Muscle and joint stiffness, particularly in the morning 1, 2
- Hyperalgesia (increased sensitivity to pain) and allodynia (pain from normally non-painful stimuli)
Associated Symptoms
- Fatigue that doesn't improve with rest 1
- Sleep disturbances and non-restorative sleep 1, 2
- Cognitive difficulties (often called "fibro fog"), including:
- Mood disturbances:
Symptom Subtypes
Fibromyalgia can be categorized into different predominant symptom patterns 1:
- Pain-predominant
- Fatigue-predominant
- Cognitive-predominant
- Mood-predominant
Impact on Daily Life
The constellation of fibromyalgia symptoms significantly impacts:
- Physical functioning
- Social relationships
- Work productivity
- Psychological wellbeing
- Overall quality of life 1
Important Clinical Considerations
Diagnostic Challenges
- Diagnosis is often delayed, taking more than 2 years with an average of 3.7 consultations with different physicians 1
- No specific diagnostic biomarkers exist; diagnosis is based on clinical presentation 2
- Symptoms often fluctuate in intensity over time
Pathophysiological Understanding
Current understanding suggests fibromyalgia involves:
- Central sensitization with hyperexcitability at spinal/brainstem level
- Altered pain perception
- Dysfunction in pain-inhibitory systems
- Potential genetic predisposition 1, 2
Common Pitfalls in Symptom Recognition
- Symptoms may overlap with other conditions, leading to misdiagnosis
- The widespread nature of pain may be misinterpreted as multiple separate conditions
- Psychological symptoms may be overemphasized, leading to dismissal of physical symptoms
- Cognitive symptoms may be attributed to aging or stress rather than recognized as part of fibromyalgia
Prevalence and Risk Factors
- Third most common musculoskeletal disorder after lower back pain and osteoarthritis 2
- More prevalent in women than men
- Most commonly diagnosed between ages 30-35, but can occur at any age 2
- Prevalence increases with age 4
Understanding this constellation of symptoms is crucial for early recognition and appropriate management of fibromyalgia, which significantly impacts patients' quality of life.