What are the Symptoms of Fibromyalgia?

Introduction to Fibromyalgia Symptoms

Classic Fibromyalgia Symptoms 

  • excessive episodes of pain in specific areas, especially neck and back pain, headaches, and abdominal pain (irritable bowel syndrome)
  • cannot sleep, or just never feel rested
  • fatigue, exercise intolerance
  • mood disorders (depression, anxiety disorder), and mental fog (the infamous “fibrofog”)

Many fibromyalgia symptoms are maddeningly non-specific: that is, they could be the symptoms of practically anything… or nothing. Headaches are the single most common pain complaint, but most have no specific cause. Most diseases cause fatigue! And pain is the most basic response to biological adversity that there is. And every other person you pass on the street is depressed, anxious, insomniac, or all of the above. It’s almost like fibromyalgia’s symptoms are just a list of the most common sufferings of humanity. It’s only when they cluster and persist — a strong, stubborn pattern dominated by pain — that the idea of fibromyalgia should be taken seriously.

Fibromyalgia Myths vs Facts

Myth #1: It’s All in Your Head

Fact: For people who experience the pain and other symptoms associated with fibromyalgia, the disorder is all too real, says Dr. Goldenberg.

The condition causes “chronic, widespread muscle pain,” he notes. “By the time people see doctors, it’s usually many months or years” since symptoms began.

But many doctors, Goldenberg laments, still don’t understand the condition.

“Most doctors think that if your elbow hurts, or your knee hurts, or your shoulder hurts, the pathology is directly in those areas,” he says. “In fibromyalgia, that doesn’t work. The pain is actually coming from the brain.”

This misunderstanding of the origins of the pain, says Goldenberg, is “one of the reasons it’s very controversial, and was for a long time kind of pooh-poohed as, ‘it’s all in your head.’”

Myth #2: Fibromyalgia Is a ‘Catchall’ Diagnosis

Fact: Fibromyalgia has specific diagnostic criteria, developed by the American College of Rheumatology (ACR).

Many people are under the impression that fibromyalgia is a “catchall” or “fallback” diagnosis because there isn’t any single test or obvious symptom used to diagnose it.

“There’s very little to see on a physical exam,” Goldenberg says. “Laboratory tests are unremarkable.”

According to the ACR, fibromyalgia is diagnosed based on the following factors:

  • Multiple painful areas of the body (on both sides, above and below the waist)
  • Additional symptoms, like fatigue, poor sleep, and difficulty thinking or concentrating
  • Symptoms that last for at least three months
  • No other apparent cause of these symptoms

Myth #3: Fibromyalgia Only Affects Women

Fact: Between 75 and 90 percent of people diagnosed with the disorder are women, according to the National Fibromyalgia Association (NFA).

Fibromyalgia affects about 10 million adults in the United States, the NFA says, which means that between 1 million and 2.5 million men in the United States have been diagnosed with fibromyalgia.

But Goldenberg says that the actual incidence among men may be even higher, since gender-based bias may play a role in how doctors diagnose fibromyalgia.

Myth #4: Fibromyalgia and Arthritis Are the Same Condition

Fact: Fibromyalgia and arthritis have little in common, other than sensations of pain and fatigue.

Unlike arthritis, fibromyalgia “doesn’t primarily affect joints. It affects muscles and soft tissue,” says Goldenberg.

And unlike arthritis and other rheumatic (arthritis-like) disorders, fibromyalgia isn’t a disease characterized by inflammation. In fact, markers of inflammation tend to be normal.

Instead of the pain coming from an inflamed area of the body, in fibromyalgia, “The pain is actually coming from the brain, from the central nervous system,” says Goldenberg.

Myth #5: A Special Fibromyalgia Diet Is Needed

Fact: No specific diet has been shown to reduce fibromyalgia symptoms, according to the National Institutes of Health (NIH).

Instead, you should simply focus on following a healthy, balanced diet that includes whole grains, lean protein sources, low-fat dairy products, fruits and vegetables, and plenty of water.

It’s also a good idea to limit your consumption of caffeine, refined sugars, fried foods, red meat, processed foods, and alcohol.

Myth #6: Complementary and Alternative Treatments Are Pointless

Fact: Meditative movement therapies — such as tai chi, yoga, and qigong — appear to improve fibromyalgia symptoms, according to a review published in January 2013 in the journal Rheumatology International. (1)

In this study, measured improvements were seen in the areas of sleep disruption, fatigue, and depression.

And in a study published in November 2017 in the same journal, a connective tissue massage was found to help with pain, fatigue, and sleep disruption in women with fibromyalgia. (2)

Myth #7: You Should Avoid Exercise

Fact: Exercise is the single most effective treatment for fibromyalgia, according to the American College of Rheumatology.

Aerobic exercise, in particular, has been shown to be helpful in reducing fibromyalgia symptoms. This includes activities like walking, biking, swimming, and water aerobics.

But Goldenberg believes that stretching and strength training are also helpful for many people. Strength training can mean using weights, exercise machines, exercise bands, or your own body weight for resistance.

While exercise may be painful or difficult at first if you have fibromyalgia, regular physical activity can help improve your symptoms and make exercising easier.

Myth #8: You’re Just Tired

Fact: Fatigue in fibromyalgia goes far beyond just being tired. As Goldenberg notes, the condition causes “a tremendous amount of fatigue. People are very exhausted.”

While fatigue is a common symptom of fibromyalgia, an article published in November 2013 in the journal Arthritis Research & Therapy concludes that it doesn’t occur in isolation. (3)

Instead, fatigue in fibromyalgia is interwoven with other symptoms — including pain, sleep disruption, and mood disturbances — and all of these symptoms can influence one another.

Myth #9: You Can Take a Pill to Make Fibromyalgia Symptoms Disappear

Fact: Drug treatments don’t work very well for many people with fibromyalgia.

“The truth is, we don’t have very good medications,” says Goldenberg. “They work well in maybe one out of three or four patients.”

While you may see some benefit from taking a drug approved to treat fibromyalgia, your symptoms will probably just diminish, not disappear.

You’ll probably also still need to incorporate lifestyle measures, like exercise, stress reduction, good sleep habits, and possibly cognitive behavioral therapy (CBT), into your treatment plan.

Myth #10: There’s Nothing You Can Do

Fact: While there’s no cure for fibromyalgia — and medication doesn’t work for everyone — there’s still a wide range of options available for treatment.

“Nonpharmacological approaches actually work as well, or maybe even better,” than drugs for many people with fibromyalgia, Goldenberg notes.

If your current treatment isn’t giving you the relief you need, work with your doctor to try something new, whether it’s exercise, prescription drugs, over-the-counter (OTC) pain relievers, or alternative treatments, like massage or meditative movement.