Fibromyalgia Symptoms

Fibromyalgia is often described as a condition that causes widespread pain. That is true, but it is also only part of the story.

Fibromyalgia can affect how you feel physically, how well you sleep, how much energy you have and even how clearly you can think. One person's experience can look quite different from another's, and your own collection of symptoms may change over time.

If you are newly diagnosed, it can be reassuring to discover that something you have been experiencing may be recognised as part of Fibromyalgia. At the same time, a long list of possible symptoms can become confusing. When a condition can affect you in so many ways, it is very easy to start wondering whether everything is Fibro.

In this guide, we'll look at the main symptoms associated with Fibromyalgia, what some of the medical terms actually mean and how those symptoms can vary. It isn't intended as a checklist for diagnosing yourself. Fibromyalgia shares symptoms with many other conditions, and new or changing symptoms should not automatically be put down to Fibro.

What Are the Main Symptoms of Fibromyalgia?

Widespread pain is generally considered the main symptom of Fibromyalgia, but it rarely exists in isolation. Current NHS guidance on Fibromyalgia Symptoms recognises a collection of symptoms that can include fatigue, unrefreshing sleep, problems with concentration and memory, stiffness and increased sensitivity.

That list is a useful starting point, but it still doesn't show what living with these symptoms can actually be like. Even something as apparently straightforward as pain can mean several quite different sensations.

So let's look at the symptoms individually, beginning with the one Fibromyalgia is probably best known for.

Widespread Pain

Widespread pain is the symptom most strongly associated with Fibromyalgia. Rather than being confined to one injured joint or a single area of the body, the pain can be felt across multiple areas of the body.

Even the word pain doesn't describe one single sensation. The pain doesn't always feel the same either. It might be a deep ache, a burning pain or arrive in sharp, stabbing bursts. The type and intensity of pain can also vary, both between different people and within the same person over time.

You may find that some areas are more troublesome than others, or that the places that hurt most change. Pain can also fluctuate in intensity, so having a relatively manageable day doesn't necessarily mean tomorrow will feel the same.

I experience several different types of pain. Sometimes, especially during the colder months, I get what I can only describe as a deep, bone-like ache. It is really pervasive and can happen in any or all of my limbs. Muscle pain feels quite different. This can appear as though I have suddenly sprained something. I can take a few steps across a room and suddenly find I can barely put my foot down. It feels much like it would have done in my pre-Fibro days if I had rolled my ankle, except there has been no injury to explain it.

Then there are the shooting pains. Several years ago, I had an accident where I partially severed the nerves and tendons in the two fingers furthest from my thumb on my right hand. They were operated on and are now not too bad, other than a semi-numb sensation along the inner edges of both fingers. While I was recovering, I often experienced shooting pains running through them. That is exactly what some of my Fibro pain feels like now. It sometimes still happens in those two fingers, but I can experience the same shooting sensation elsewhere in my body too.

Another type is harder to describe. Sometimes I can have pain that feels remarkably like an ear or sinus infection, running from my lower jaw right up to the top of my head. The important difference is that there isn't actually an infection causing it.

Increased Sensitivity to Pain

Fibromyalgia doesn't only cause pain. It can also change how strongly you experience something painful and even make sensations hurt that wouldn't normally be painful.

Two terms you may come across when reading about Fibromyalgia are hyperalgesia and allodynia.

Hyperalgesia means having an increased response to something that would normally hurt. For example, something that might cause relatively minor discomfort for another person can feel considerably more painful when you have Fibromyalgia.

Allodynia is slightly different. This is when something that wouldn't normally be painful causes pain. A light touch, pressure from clothing or even something gently brushing against the skin can hurt.

Neither means that the pain is imagined or that you are simply less able to cope with it. The pain itself is real; the difference lies in how the nervous system processes and responds to sensory signals.

A recent example of allodynia happened during a heatwave. I was getting by sitting in front of a fan, but after a while even the air propelled by the fan began to hurt my skin. I also have ongoing problems with fabrics. There are certain materials, such as denim, that are nearly impossible for me to wear. Actually, forget nearly. They are impossible!

Tender points were once used as part of the diagnostic process for Fibromyalgia, although they are no longer required for diagnosis. I still experience extreme tenderness in some areas of my body. The easiest way I can describe it is that even the gentlest fingertip pressure in one of these areas can be agonising. Move that finger a few centimetres and I may feel only minor discomfort, but press the particularly tender area and it can feel as though enough pressure has been used to break a bone.

Perhaps my worst experience of increased pain sensitivity happens when my blood pressure is taken. I remember the cuff being a minor discomfort in my "old life". Now, as it tightens around my arm, it can feel as though a bone is being broken. Ironically, I suspect the act of taking my blood pressure probably isn't doing the reading any favours!

Fibromyalgia Fatigue

Fatigue is another major symptom of Fibromyalgia, but the word can be misleading. Everyone gets tired, particularly after a busy day or a poor night's sleep. Fibromyalgia fatigue can go considerably beyond ordinary tiredness.

It can range from a persistent lack of energy to overwhelming exhaustion that makes everyday activities difficult.

Fatigue can also interact with other Fibromyalgia symptoms. Pain can make activities more demanding, poor-quality sleep can leave you starting the day without feeling refreshed, and trying to think through Fibro Fog can be tiring in itself. On a difficult day, these symptoms don't necessarily arrive neatly one at a time.

I would describe Fibromyalgia fatigue as living with a faulty battery. However long you plug yourself in, whether through sleep or rest, it is impossible to become fully charged. So even when I am doing well, there is always a limited supply of energy.

The reality of living with this level of fatigue is that even going downstairs in the house becomes a planned excursion. I often go two or more weeks at a time without venturing downstairs. It isn't so much the going down that is the issue, it is knowing that I have to get back up again. Once you add that to the ever-present possibility of suddenly feeling as though I have sprained an ankle, movement has to be thought through. I am very lucky that this hasn't happened when I have had to leave the house. Small blessings.

On worse days, the fatigue can feel similar to the level of exhaustion you might experience when you have flu. Making it from the bed to the commode can be the most movement I can hope for. When this level of fatigue settles in, it can be weeks, and sometimes months, before the better days arrive again.

Sleep That Doesn't Refresh You

Sleep and Fibromyalgia can have a frustrating relationship. You might expect that after sleeping for several hours you would wake feeling rested, but Fibromyalgia can be associated with unrefreshing or non-restorative sleep. In simple terms, you can sleep without feeling as though your body has properly benefited from it.

Some people with Fibromyalgia also experience disrupted sleep, waking frequently during the night or struggling to sleep deeply enough to feel restored. Pain and other symptoms can make getting comfortable difficult too, creating another complication when your body desperately needs rest.

The result can be waking in the morning already feeling tired, sometimes regardless of how long you have been asleep.

Sleep problems can have causes other than Fibromyalgia, and conditions such as sleep apnoea can occur alongside it. Persistent or significant problems with sleep are therefore worth discussing with a healthcare professional rather than automatically assuming Fibro is responsible.

I have a bit of a difficult relationship with sleep, with various vicious circles happening. When I do sleep "properly", I can have episodes of heavy snoring and sometimes wake up with a headache. Knowing that I may wake with a headache, part of me wants to make the most of the time when I am feeling relatively well. So I can find myself battling sleep to carry on reading, watching YouTube or playing games on my phone.

Then there is painsomnia, when I am desperately trying to go to sleep but various parts of me are hurting and the pain is enough to keep me awake. Or I finally get to sleep, roll over, trigger the pain and wake myself straight back up again.

It is fair to say that with all the tossing and turning I do looking for comfort, even with a brand-new mattress and topper, I probably get more exercise in bed than I do during the daytime. And no, not that sort of night-time exercise. I have Fibromyalgia, it would probably kill me!

I've written more about my complicated relationship with sleep in Complex Sleep Problems and Fibro.

Fibro Fog and Cognitive Symptoms

Pain and fatigue are physical symptoms that people may readily associate with Fibromyalgia, but the condition can also affect how clearly you are able to think. These cognitive difficulties are commonly known as Fibro Fog.

Fibro Fog can affect concentration, attention and memory. You might struggle to take in new information, lose track of what you were doing or find that something you normally know simply won't come to mind when you need it.

Finding words can be particularly frustrating. You may know perfectly well what you want to say but be unable to retrieve the word, or lose your train of thought halfway through a sentence.

The severity can fluctuate just like other Fibromyalgia symptoms. A relatively clear-headed day can be followed by one when reading, following a conversation, making decisions or completing a task that requires concentration takes considerably more effort.

Fibro Fog isn't a reflection of intelligence or knowledge. The information may still be in there; sometimes getting your brain to find and use it is the difficult part.

I experience Fibro Fog in various ways. Just today, I had to set three security questions and answers for an account. I then went to my password manager to make a note of them and, for the life of me, I couldn't remember what I had written for the third answer only moments before. I'm having a pretty good day too!

Tiredness always makes my Fibro Fog worse. When I know it is playing up, I become nervous about using the telephone unless I'm talking to someone I know well. There is a good chance I will lose a word, or even my whole train of thought, halfway through a conversation.

One little way I try to get my Fibro Fog bearings is by using a brain-training app each day. As well as giving me some cognitive exercise, it gives me a useful personal benchmark. Sometimes my performance drops noticeably on a bad day before I have even clocked for myself that the Fog is particularly bad.

Then there was the time I bought a second laminator. I knew I already owned one; I just had absolutely no idea where it was. That particular episode of Fibro Fog ended up triggering the creation of my home inventory system.

Stiffness

Stiffness is another common symptom of Fibromyalgia. It can affect different parts of the body and may make movement feel uncomfortable or more difficult.

You might notice it particularly after your body has been in the same position for a while. This can mean feeling stiff when you first get out of bed, after sitting for a long time or even after simply remaining still while resting.

The stiffness can exist alongside pain, which can make getting moving particularly difficult. How troublesome it is can also vary from day to day, just as other Fibromyalgia symptoms do.

My main problem with stiffness comes when I have been sitting in my computer chair for too long. I can easily get caught up and fixated on what I am doing, then before I know it I need to get up and find myself almost bent double for a while. Thankfully, it is usually short-lived once I start moving.

Another situation that can trigger stiffness for me is holding crafting tools for too long. I suffered quite badly with this during my early days of diamond painting. My hand could become so stiff and painful that I would feel it for the rest of the day.

I've adapted how I craft because of that. Now I make sure I never diamond paint for more than an hour in one sitting, and usually no more than an hour in a day. It means I can still enjoy the hobby without quite so much protest from my hands afterwards.

Sensory Sensitivity

Increased sensitivity with Fibromyalgia isn't necessarily limited to pain. Some people find that their body reacts more strongly to other kinds of sensory input too.

Temperature can be particularly troublesome. You may feel excessively hot or cold, or find changes in temperature harder to tolerate than you once did.

Sensitivity to light and noise can also occur. Bright or flashing lights, loud sounds or environments where several things are competing for your attention at once may become uncomfortable or overwhelming.

UK clinical guidance also recognises sensitivity to sensory stimuli including temperature, light, sound and odours as part of the wider Fibromyalgia symptom picture. As with other symptoms, this varies considerably. Someone with Fibromyalgia won't necessarily experience every type of sensitivity, and those they do experience may be much more troublesome at some times than others.

Loud noises are one of my most common sensory triggers. When the house alarm has to be tested, I need to put my fingers in my ears. If I am caught out by a sudden loud noise, I can still seem to hear it for up to an hour afterwards, although my episodes of tinnitus no doubt complicate that experience.

Another sensory issue that affects me is my sense of smell. I have been completely overwhelmed by an ordinary surface cleaner and had to leave the room after it was sprayed. Although I don't have much occasion to wear fragrance these days, when I do I need to choose a milder eau de toilette. A full-strength perfume would simply be too much for me.

Other Symptoms You May Experience

The symptoms we've covered so far are some of the major features associated with Fibromyalgia, but they aren't the end of the list. There are several other symptoms that people with Fibromyalgia may experience.

These can include:

• Headaches, which may range from ordinary headaches to frequent or severe headaches
  
• Dizziness and feeling unsteady or clumsy
  
• Pins and needles, tingling or numbness, particularly in the hands and feet.
  
• Restless legs, including an uncomfortable urge to keep moving your legs
  
• Painful periods
  

You may experience several of these, only one or two, or none at all. Their severity can fluctuate too, just as pain, fatigue and other Fibromyalgia symptoms can.

A long list like this can make Fibromyalgia seem capable of explaining almost anything that happens to your body. That is where things become a little more complicated. Some health problems occur more frequently alongside Fibromyalgia without necessarily being symptoms caused by Fibromyalgia itself.

Before we look at that distinction, though, it is worth remembering something important: you don't need to experience every symptom associated with Fibromyalgia for your experience of the condition to be valid.

Conditions That Can Occur Alongside Fibromyalgia

Fibromyalgia doesn't always travel alone. Some people also live with other conditions, including irritable bowel syndrome (IBS), anxiety and depression.

It is useful to distinguish between a symptom of Fibromyalgia and a separate condition that can occur alongside it. The two can overlap and influence one another, but having Fibromyalgia doesn't necessarily mean that Fibromyalgia itself is causing every health problem you experience.

I have covered this in more detail in Fibromyalgia and Associated Symptoms, including some of the conditions and additional problems that have formed part of my own experience.

Fibromyalgia Symptoms Can Change

One of the difficult things about Fibromyalgia is that its symptoms aren't necessarily predictable or consistent. They can vary between people, but they can also change considerably within the same person.

You may have symptoms that are present most of the time and others that seem to come and go. Their severity can fluctuate too, so the symptom causing you the most difficulty may not always be the same one.

There may also be periods when several symptoms become noticeably worse together. These are often described as Fibromyalgia flare-ups or simply flares. A flare can last for different lengths of time and doesn't necessarily look exactly the same each time.

Feeling relatively well today doesn't guarantee that you will have the same amount of energy or the same level of symptoms tomorrow. Equally, a particularly bad period doesn't necessarily mean that every future day will be that difficult.

Over a longer period, your experience of Fibromyalgia may change too. Symptoms that were once particularly troublesome may become less prominent, while others can become a bigger part of your life.

When I look back over my Fibromyalgia journey, I would have to say that although I can still have relatively good days, my overall average has got worse. At the same time, I have learnt how to adapt.

In the early days, I was taking the full prescribed dose of painkillers every day. For me, that left me feeling as though I had nowhere to go when things were particularly bad. Over time, I gradually tapered down and now only take them when my symptoms are worse. This means that on a typical day, when I would previously have taken painkillers, I now manage without them. That is what has worked for me; changes to prescribed medication are something to discuss with your own healthcare professional.

My symptoms can fluctuate enormously. I can go from my highest pain levels back to my current normal, or the other way around, in not just hours but sometimes minutes. Equally, when I have a bad flare, it can last far longer. In the early days, a week out of action felt like a bad spell. In more recent years, I have been pretty much bed-bound for three months at a time, usually because of fatigue more than pain.

Interestingly, although things are worse on paper, I have also adapted to manage them better, so the bigger picture doesn't necessarily feel worse. I now recognise and accept fairly quickly when I am having a flare and start thinking about what I can do to distract myself while I am bed-bound. In the early days, the same situation would fill me with frustration and guilt because I couldn't do more.

So, although my limitations have increased over the years, I have gradually become much better at living within them.

Is This Fibromyalgia or Something Else?

When you live with a condition that can cause such a wide range of symptoms, it becomes very easy to put every new ache, pain or strange sensation into the Fibromyalgia basket.

Sometimes it may well be Fibro, but having Fibromyalgia doesn't protect you from developing other illnesses or health problems. Symptoms can overlap between different conditions too, which means something that feels familiar isn't necessarily caused by the same thing.

That doesn't mean becoming anxious about every small change in your body. It does mean paying attention to symptoms that are new, significantly different from your usual pattern, persistent or concerning, and seeking medical advice when appropriate.

I've learnt this lesson myself. In Not Every Symptom Belongs in the Fibro Basket, I share what happened when symptoms I could easily have dismissed as another part of Fibromyalgia led my doctor to investigate further.

Fibromyalgia may explain a lot, but it shouldn't automatically be allowed to explain everything.

Do These Symptoms Mean I Have Fibromyalgia?

Recognising many of the symptoms in this article doesn't necessarily mean that you have Fibromyalgia. Pain, fatigue, poor sleep, cognitive difficulties and many of the other symptoms we've discussed can occur for numerous reasons.

There is no single blood test, scan or other laboratory test that can confirm Fibromyalgia. Diagnosis is based on your symptoms and medical history, alongside a clinical assessment. Tests may sometimes be used to investigate other possible explanations rather than to test directly for Fibromyalgia. You can read more about how the condition is assessed in the NHS guide to diagnosing Fibromyalgia

Current UK guidance looks at the overall pattern of symptoms, including widespread pain and problems such as fatigue, unrefreshing sleep and cognitive difficulties. Having another health condition doesn't necessarily rule out Fibromyalgia either; it is possible to have Fibromyalgia alongside other conditions.

If you recognise your own experiences here and don't already have a diagnosis, the next step is to talk to your GP or another appropriate healthcare professional about what you have been experiencing.

Keeping a simple record of your symptoms, when they occur and how they affect you can make that conversation easier, particularly when there is a lot to remember.

Living With a Collection of Symptoms

One of the hardest things about Fibromyalgia can be that its symptoms don't exist neatly in isolation.

Pain can make it harder to sleep. Poor sleep can leave you more fatigued. Fatigue can make concentrating more difficult, while Fibro Fog can turn an otherwise simple task into something requiring far more effort. Add stiffness or sensory sensitivity into the mix and an ordinary day can suddenly demand considerably more from you.

Sometimes it isn't the severity of any one symptom that causes the greatest difficulty, but the cumulative effect of several symptoms happening together.

Over time, you may begin to recognise your own patterns and understand which combinations of symptoms tend to make a day particularly difficult. That doesn't make Fibromyalgia predictable, but it can make your own experience of it a little easier to understand.

If you're newly diagnosed or still trying to make sense of what is happening to you, you don't need to learn how to manage every symptom at once. Getting to know your own Fibromyalgia takes time.

Where to Go Next

If you're still getting to grips with the condition itself, What Is Fibromyalgia? takes a step back from individual symptoms and looks at the bigger picture of Fibromyalgia, including what it is and how it is diagnosed.

There is a lot to take in, particularly if Fibromyalgia is new to you. You don't need to understand every symptom or work everything out at once.

Most importantly, remember that a list of symptoms can describe Fibromyalgia, but it can't describe your Fibromyalgia completely. Your combination of symptoms, their severity and the way they affect your life will be individual to you.