Fibromyalgia is one of the few health problems that knows no boundaries. These patients can experience almost all types of pain and many signs and symptoms that do not appear to have any connection to each other. Some of them improve significantly after pain management therapy. Others require a combination of physical therapy, drugs, and emotional or psychological evaluations.
While many questions remain without an answer, we can still suspect the disease by some give-out signs. It is a chronic disease, so one or two symptoms once in a while does not mean you have fibromyalgia. But if you’re a middle-aged woman who constantly feels weak, tired, and experiences pain in different parts of the body that does not respond to medications, one of the disorders worth ruling out is fibromyalgia.
The right specialist to visit if you have symptoms in this list is a rheumatologist. These physicians specialize in rheumatoid arthritis, but they also have the training to diagnose fibromyalgia. This is a neurosensory disorder that typically originates in the central nervous system, and it is not limited to pain as the only manifestation.
In this article, you will have a complete list of signs and symptoms of fibromyalgia. You will see that it is a complex disease, and what every symptom has in common is that it not a temporary problem. It is a chronic disease with far-reaching consequences.
Signs and symptoms of fibromyalgia
These are the most important signs and symptoms of fibromyalgia. The disease is variable, and experiencing all symptoms is not a requirement to suspect the diagnosis of this disease. You can start experiencing any of these symptoms as an early sign or over the course of the disease:
1.Pain in multiple trigger points
Pain is perhaps the most salient symptom of fibromyalgia. Several changes in the central nervous system and increased sensitivity in the peripheral nerves increase the sensation of pain in different parts of the body. Pain symptoms are not limited to headaches or pain in the articulations. Instead of being localized, this pain becomes widespread and often difficult to localize. When other diseases are also present, it might be difficult to differentiate which symptoms are triggered by fibromyalgia and which ones are caused by the overlapping illness.
In fibromyalgia, there are several trigger points throughout the body that are usually painful. Some of them are close to bony structures and organs that become tender to the touch. Doctors use these trigger points to diagnose fibromyalgia and may need to apply a bit of pressure in each to see where it hurts.
In fibromyalgia, pain nerve terminals are activated in response to inflammation or may become triggered spontaneously. Your hormones, stress, and specific emotions may contribute to the problem.
2.A reduction in the pain threshold
One of the reasons patients with fibromyalgia experience so much pain is that their pain threshold decreases. In other words, they are more sensitive to pain. This comes from an alteration in their brain chemistry and hypersensitivity of their peripheral nerves. In more advanced diseases, even mild pressure or a simple touch causes significant pain. If the patient has a condition that triggers pain, this reduction in their pain threshold may increase the sensation and cause excruciating pain. Thus, the patients become vigilant about anything that triggers pain, and this psychological predisposition further contributes to lowering their pain threshold.
Stimuli that usually does not cause pain such as cold, heat, or a simple touch becomes painful for these patients. This often makes everybody question the patient about his symptoms, thinking that they are faking or exaggerating their symptoms. But there’s an organic cause, and the disease can be detected after a careful physical exam and a few studies.
3.Muscle pain and joint stiffness
One of the reasons why a rheumatologist is the one that diagnoses fibromyalgia is that the disease coexists with other inflammatory health problems, especially rheumatoid arthritis and autoimmune conditions. By themselves, these conditions cause joint pain, stiffness, and myalgia (muscle pain). They are further intensified by fibromyalgia and higher pain sensitivity. This weakens the patient’s body and causes a constant sensation of tiredness.
Sometimes fibromyalgia triggers joint pain and muscle pain without any other rheumatoid disease. The reason is a current field of research, and it appears that muscle pain is the cause of stiffness, similar to what happens when you have an intense workout and end up feeling soreness and difficulty moving. The same sensation is maintained for a long time in fibromyalgia patients and causes a severe reduction in their quality of life.
4.Circulation problems and tingling
In patients with fibromyalgia, one of the most uncomfortable problems is feeling constant tingling in the skin, usually in the upper or lower limbs. This sensation is reported by around 30% of patients with fibromyalgia, and it is sometimes linked with circulation problems. In other cases, the sensation comes from the nervous system, and it is known as paresthesia.
One way to know if this tingling is circulatory or nervous in patients with fibromyalgia is by evaluating if the patient also has muscle spasms and a sensation of stiffness when experiencing the symptom. If they do, there is probably a nervous cause. In other cases, there is a compression of the blood vessels similar to what happens when you put on a cold compress for a long time. This is known as cold-induced vasospasm, except that fibromyalgia patients trigger this problem without cold temperatures. The exact cause is obscure and difficult to explore, but the symptom is more common still in patients with diabetic neuropathy, multiple sclerosis, and other nerve-related problems.
5.Sleeping problems
Fibromyalgia patients usually have an alteration in their sleep pattern. This is expected in patients who feel pain and discomfort at all times and do not find a comfortable position to sleep. Additionally, these patients have an alteration in their circadian rhythm caused by an increase in metabolic stress and a constant sensation of pain.
Almost all patients with fibromyalgia report this symptom. They are sometimes unable to sleep or experience unrestful night sleep and daylight somnolence. These patients can have low levels of a neurotransmitter called serotonin, making them susceptible to mood swings and sleep pattern alterations.
Sleep deprivation by itself contributes to other fibromyalgia symptoms, including metabolic problems, hormonal imbalances, and neuroendocrine disease. One of the hormones that become altered in these cases is known as growth hormone. It is beneficial for muscle growth, bone density, and tissue healing in adults.
6.Nervousness and anxiety
There is an emotional part associated with the symptoms of fibromyalgia. It is a fact that your mood affects how you perceive pain, which is particularly evident in these patients. They usually feel anxious and nervous throughout the day and are easily triggered to become angry. This increases their sensitivity and lowers the pain threshold.
Glutamate is one of the neurotransmitters associated with this effect. This is an excitatory neurotransmitter and one related to the sensation of pain. This makes patients more likely to be vigilant all day long and feels uneasy. The constant state of vigilance, nervousness, and anxiety has a pain-triggering effect, and the whole process turns into an endless loop.
7.Mood swings
In most cases, fibromyalgia is deeply intertwined with mood disorders and overlaps with emotional problems such as depression and phobia. By itself, the disease also triggers these problems or makes them worse. Initially, the mood swings are a part of a defense mechanism to prompt you to look for the pain source and protect your body from harmful elements. But since no change can be made, the patient feels frustrated and tends to become very irritable.
Chronic pain in fibromyalgia creates a state of sustained stress, and there’s a limit as to how much stress we can endure. At some point, we reach the threshold and suffer a breakdown characterized by anxiety and depression. As noted above, these emotions may also amplify the pain and create a loop. Thus, even if it seems very difficult, maintaining your emotions under control is a part of the therapy.
8.Chronic fatigue
In different parts of this article, we have mentioned chronic fatigue elements, including tiredness, weakness, and reaching the threshold of how much stress the body can endure. Apparently, these patients are living a sedentary life with no particular reason to feel exhausted. However, they do feel fatigued because pain creates metabolic stress in their body, and they burn more energy than usual. Additionally, they constantly experience sleep problems, as noted above, which contributes to their daylight drowsiness and fatigue.
Furthermore, according to studies, patients with fibromyalgia are very likely to suffer from metabolic syndrome, and one cause can be chronic fatigue and chronic pain. Thus, it is essential to address fatigue in treating this disease to improve their quality of life and the incidence of associated health problems.
9.Cognitive impairments
In many cases, patients with fibromyalgia start displaying brain abnormalities that translate into memory problems, attention, or retention problems. Their neurochemical disorder is sometimes not only limited to a higher sensitivity to pain. According to studies, their short-term memory is affected by the disease, and the problem gets worse over time. After some time, it will be difficult for them to remember new data and learn new things.
This is not only a subjective problem. It is also measured objectively through imaging tests. According to brain studies, fibromyalgia patients have a low blood flow in certain parts of the brain, and these areas are associated with memory and concentration. They also have neurotransmitter abnormalities, especially in the neurotransmitters serotonin, dopamine, substance P, and norepinephrine. Additional to all of this, pain by itself causes a distraction at the moment and affects the capacity of patients to concentrate and gather new recollections.
10.Gastrointestinal issues
The gastrointestinal system is deeply linked with nerve function, and there’s a brain-gut axis that we should consider in these patients. What happens in the gut affects the brain, and what happens in the brain affects the gastrointestinal system. As a result, fibromyalgia patients often suffer from inflammatory diseases of the gastrointestinal tract, especially irritable bowel syndrome and Crohn’s disease or ulcerative colitis. They may also have gastrointestinal symptoms more frequently than the average without being diagnosed with these conditions.
In inflammatory bowel conditions, there is sustained inflammation in the mucosa of the gastrointestinal system, leading to the formation of ulcers in the long run. Usual symptoms in these cases include diarrhea, constipation, bloating, or an upset stomach. The symptoms are worsened during menstrual periods and in patients with a food sensitivity or food intolerance.
Conclusion
Fibromyalgia is a very complex disease, and there is still much to learn about this condition before achieving a complete cure. So far, we only have ways to improve the symptoms. However, new treatments have been made available through the years, and rheumatologists are trained to find valuable solutions according to how fibromyalgia develops in your case.
Every case of fibromyalgia feels different, and you can’t compare yourself to other patients. Thus, it is essential to understand the disease if you want to detect the problem from an early stage.
If you read the signs and symptoms of fibromyalgia above and recognize some of them in your case, it is important to talk to your doctor to find out what happens. Signs and symptoms of fibromyalgia are also found in many other diseases, and they need to rule out more common causes before turning to this diagnosis. After being diagnosed, you will have personalized treatment according to your manifestations of the disease and will be recommended a series of lifestyle changes that may also contribute to solving the problem.