Checking the list
Fibromyalgia can feel different for everyone, which is part of the reason it’s so difficult to diagnose.
There is no blood test for the condition, and doctors cross off other conditions and check for fibromyalgia symptoms and tender points to reach a diagnosis.
While the most common symptom is body pain, there are other symptoms that sometimes fly under the radar. Recognizing these symptoms, and getting treatment, may help.
Anxiety or depression
Being in constant pain can lead to anxiety and depression.
However, many people with fibromyalgia continue to thrive, despite the pain. The key to coping is accepting the problem and learning how to minimize the pain—even if it can’t be cured completely, experts say.
“Fibromyalgia seems to be a problem with the brain in the way that it transmits pain,” says Daniel J. Clauw, MD, the director of the Chronic Pain and Fatigue Research Center at the University of Michigan. “The neurotransmitters that are involved in pain transmission [are also involved in] mood.”
Fibromyalgia patients often report digestive problems that are usually related to irritable bowel syndrome (IBS), which has symptoms that include abdominal pain and constipation or diarrhea.
“Fibromyalgia has come to mean more than just widespread pain,” says Dr. Clauw. “It’s the poster child for a constellation [of symptoms] including IBS, interstitial colitis, and chronic fatigue.”
Doctors aren’t sure why these two conditions often occur together. One theory is that fibromyalgia medications may be exacerbating constipation, or IBS medications may be causing muscle aches and fatigue.
More than 80% of people with fibromyalgia experience fatigue, says Dr. Clauw. Consequently, fibromyalgia is often compared to chronic fatigue syndrome and sometimes diagnosed as such.
Nearly half of fibro patients, if not more, also meet the criteria for CFS, according to Dr. Clauw. In both, patients may experience feelings of tiredness that are so strong they impede school, work, or other daily activities.
In addition to body pain, people with fibromyalgia also are prone to chronic headaches.
A 2004 study found that 76% of treatment-seeking fibromyalgia patients reported chronic headaches, and of fibromyalgia patients with headaches, 63% had migraines.
Research has shown that fibromyalgia patients lose more than three times as much “gray matter” brain tissue than their healthy peers, resulting in concentration and memory problems often referred to as “fibro fog.”
People with fibromyalgia may find themselves frequently confused, losing their train of thought, forgetting details, or mixing up words.
Unfortunately, even though fibro patients may feel more tired than their healthy peers, they also often have difficulty sleeping.
The catch-22 is that more sleep is likely to ease some of the pain, but people with fibromyalgia have difficulty falling or staying asleep and often don’t wake up feeling rested or refreshed. Some have trouble sleeping because of their discomfort, while others may be affected by the same neurotransmitters that may be creating the pain.
“In one area, this imbalance might cause pain,” says Dr. Clauw, “and in another, it might [affect] sleep. Very similar neurotransmitters control a lot of these functions.”
A stiff neck or creaky joint first thing in the morning is usually nothing to worry about. But for healthy patients, these morning aches and pains vanish pretty quickly after beginning the day.
In people with fibromyalgia, morning stiffness may linger for an hour or two, or make it extremely difficult to get out of bed.