Updated 28 March 2018

Signs and symptoms of fibromyalgia

What signs or symptoms do fibromyalgia patients experience?

The severity of fibromyagia signs and symptoms vary, and occur in different combinations in different individuals, but commonly include the following.

- The primary symptom of fibromyalgia is widespread musculoskeletal pain, which persists for several months and frequently affects the joints, neck and back. The pain is often accompanied by stiffness, which is characteristically worse in the morning and may last all day. Patients often wake up and feel that they have been “run over     by a bus”

- Pain typically includes multiple "tender points". These are localised tender areas that are acutely painful when moderate pressure is applied (e.g. pressing with the thumb until the nail blanches). Tender points may be found on the back of the head, the neck, upper and lower back, shoulders, upper chest, elbows, hips and knees.

- Fatigue and sleep disturbances. Fatigue occurs in 90% of people with fibromyalgia, and may be related to the disturbed sleep patterns that commonly occur with the condition. Typically, this is experienced as waking in the morning feeling tired and unrefreshed, sometimes with muscle aches.

- Some people with fibromyalgia have trouble falling asleep, or may wake repeatedly during the night. Studies suggest that this may be caused by a sleep disorder called alpha-wave interrupted sleep pattern, in which deep sleep is interrupted by bursts of "wakeful" brain activity. Thus people with fibromyalgia often lack the deep, restorative stage of sleep, called "non-rapid-eye-movement" (non-REM) sleep. 

Other sleep disorders, such as sleep apnoea, nocturnal myoclonus and restless leg syndrome, may also be associated with fibromyalgia.

- About 40% to 70% of people with fibromyalgia experience constipation, diarrhoea, abdominal pain and bloating – symptoms associated with IBS.

- Chronic headaches and facial pain. Half of people with fibromyalgia have recurrent migraine or tension headaches, which may be related to tenderness in the neck and shoulders. Up to 90% experience jaw and facial pain.

- Heightened sensitivity. About 50% of people with fibromyalgia report increased sensitivity to different sensory stimuli (such as odours, noises, bright lights, certain foods and changes in the weather), and a low pain threshold.

- Numbness, tingling or a swollen sensation in the hands and feet.

- Chest pain or pelvic pain Irritable bladder, causing frequent painful urination

- Dry eyes and mouth.

- Dizziness  

- Mental and/or emotional disturbances occur in over half of people with fibromyalgia. Such symptoms include poor concentration, forgetfulness, mood changes, irritability, depression and anxiety.

Read more: 

Causes of fibromyalgia  

Fibromyalgia is often undiagnosed in men 

What is Fibromyalgia?


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Professor Asgar Ali Kalla completed his MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 1975 at the University of Cape Town and his FRCP in 2003 in London. Professor Ali Kalla is the Isaac Albow Chair of Rheumatology at the University of Cape Town and also the Head of Division of Rheumatology at Groote Schuur Hospital. He has participated in a number of clinical trials for rheumatology and is active in community outreach. Prof Ali Kalla is an expert in Arthritis for Health24.

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