7 fibromyalgia signs, symptoms, and treatments

Fibromyalgia is a chronic pain condition that affects more than four million people in the United States (Muraleetharan, 2018).

The signs and symptoms of fibromyalgia can often be overlooked, especially in men, making getting a diagnosis tricky. Once a diagnosis is made, though, there are several treatments available that have been shown to improve the quality of life for those living with fibromyalgia.

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Fibromyalgia (FM) is a complex and often misunderstood condition. Its most notable symptom is widespread chronic pain. Currently, researchers consider FM to be a neurosensory disorder. This means that the nervous system of a person affected by fibromyalgia processes pain signals differently than it usually would (Bhargava, 2020).

Medical researchers don’t agree on the cause of fibromyalgia pain. It's most likely caused by a combination of genetics and multiple physical and emotional stressors in a person’s environment. Some of these stressors can include (Bhargava, 2020; U.S. National Library of Medicine, 2021):

• Stressful or traumatic events

• Repetitive injuries

• Viral infections

• Other serious medical problems

Getting a diagnosis of fibromyalgia can sometimes be difficult. One study showed that it took those with fibromyalgia more than two years before they were diagnosed. They visited an average of 3.7 different healthcare providers in that time (Choy, 2010).

Part of the problem is there are no specific blood tests for FM available. Your healthcare provider will conduct a thorough medical history and physical exam and may order x-rays or lab tests to rule out other health conditions. Your primary healthcare provider can diagnose fibromyalgia, but they might also refer you to a specialist such as a rheumatologist or a neurologist (Häuser, 2018).

The most notable fibromyalgia symptom is pain, but there are many other physical, mental, and cognitive symptoms that someone with FM might experience.

1. Pain

Fibromyalgia pain affects multiple soft tissue areas of the body. It is usually described as muscle pain, but joints can be affected as well. There is typically no evidence of swelling or inflammation at the tender points. Over 50% of people with FM also experience headaches, including migraines (Bhargava, 2020).

2. Fatigue

Excessive tiredness is another common symptom of fibromyalgia. This fatigue can happen first thing in the morning or mid-afternoon, and even minor activities can be exhausting. Perplexingly, a lack of exercise can also increase the pain and fatigue felt (Bhargava, 2020).

3. Brain fog 

Brain fog, also known as “fibro fog,” is the decreased ability to concentrate, memory trouble, and an inability to multitask many people with fibromyalgia experience. People with FM often report feeling like they live in a haze or like their head is full of cotton. People living with fibromyalgia frequently say that brain fog impacts their lives even more than other FM symptoms (Kravitz, 2015).

4. Digestive problems

The connection between fibromyalgia and digestive issues isn’t clear. However, people with FM experience digestive problems such as irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD) more often than the general public (Bhargava, 2020).

5. Sleep problems

Poor sleep is another common symptom experienced by people with FM. Light sleeping and frequent early morning awakening are common complaints. Even after eight to ten hours of sleep at night, people with fibromyalgia can still feel tired in the morning (Bhargava, 2020).

6. Anxiety and depression

Researchers have found that 30 to 50 percent of people with FM have anxiety or depression at the time of their diagnosis. It's not clear whether these are symptoms of fibromyalgia itself or come from living with chronic symptoms (Bhargava, 2020).

7. Other fibromyalgia symptoms

Other common symptoms that people diagnosed with fibromyalgia report experiencing include (Bhargava, 2020):

• Tingling in the arms and legs

• Dry eyes

• Trouble breathing

• Trouble swallowing

• Heart palpitations

Fibromyalgia is often mislabeled as a diagnosis that only affects women. Research shows that the prevalence of FM is actually pretty similar for both males and females. However, men are much less likely than women to report their symptoms or be diagnosed (Muraleetharan, 2018).

Men with fibromyalgia experience the same pain levels as their female counterparts. They may even have more severe or uncommon fibromyalgia symptoms. Men with fibromyalgia also tend to report (Muraleetharan, 2018):

• Worse mental and emotional health 

• Increased physical limitations

• Lower quality of life

One theory for this discrepancy is the perceived social stigma associated with being diagnosed with fibromyalgia. Researchers say that men may experience more emotional stress due to the stigma of being labeled as a “woman’s disease” (Muraleetharan, 2018).

A Swedish study found that men with FM believed that healthcare providers did not take their symptoms seriously and often felt neglected by the healthcare system (Muraleetharan, 2018).

Fibromyalgia is a chronic condition that currently has no cure. However, there are treatments to manage it and improve the quality of life for those affected. The treatment of fibromyalgia usually involves a combination of therapies. These can include medications, lifestyle changes, psychotherapy, and complementary therapies.

Medication

Researchers have studied using many different medications to manage the chronic pain associated with fibromyalgia. No particular medication has been shown to be more helpful with pain management than the others. Healthcare providers commonly recommend over-the-counter (OTC) pain relievers, the antidepressants duloxetine (Cymbalta) and milnacipran (Savella), and the anticonvulsant pregabalin (Lyrica) (Maffei, 2020).

Exercise

Exercise is generally well tolerated by people with FM and has been found to improve the ability to do daily activities. It has been shown to improve pain relief and quality of life for people living with fibromyalgia. Some types of exercise that have shown promising results include yoga, aquatic exercise, belly dancing, Zumba, and Tai chi (Maffei, 2020).

Therapy

Talk therapies such as cognitive-behavioral therapy (CBT) can help people affected by fibromyalgia learn strategies to deal with pain and stress and reframe negative thoughts about their illness. It can also help those with anxiety and depressive symptoms (U.S. National Library of Medicine, 2021).

Sleep hygiene

Research has shown that optimizing your sleep environment and prioritizing a relaxing sleep routine can help ease fibromyalgia symptoms. Practicing good sleep hygiene measures can improve pain scores and feelings of mental well-being (Arnold, 2016).

Complementary therapies

Since the number of scientifically-backed treatments for FM is limited, those living with fibromyalgia frequently seek alternative and complementary therapies to manage their symptoms. More research is still needed to tell how effective each treatment is. Complementary therapies include (Maffei, 2020):

• Acupuncture

• Thermal therapies such as body warming and cryotherapy

• Hyperbaric oxygen therapy (HBOT) 

• Low-level laser therapy

• Massage

• Probiotics

• Cannabinoids

If you are experiencing pain, brain fog, fatigue, or any other symptoms connected to fibromyalgia, talk to your healthcare provider. They can rule out any other medical conditions that might be causing your problems. 

Getting a diagnosis of fibromyalgia can be challenging. Be sure to advocate for yourself as you and your healthcare provider work to find the right diagnosis. If you are diagnosed with fibromyalgia, your healthcare provider can help you develop a treatment plan to manage your fibromyalgia symptoms.

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

July 27, 2021

Written by

Ellyn Vohnoutka, BSN, RN

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.