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One of the hallmark features of fibromyalgia is its lack of a standard course, meaning that patients rarely experience exactly the same constellation of symptoms. In general, the signs and symptoms of fibromyalgia may be grouped into primary symptoms and associated symptoms.

Primary Symptoms of Fibromyalgia

There are four primary symptoms of fibromyalgia that occur in the overwhelming majority (80% to 100%) of patients with fibromyalgia. These primary symptoms are:

• Long-standing, widespread musculoskeletal pain
• Peristent fatigue
• Generalized stiffness (particulary on awakeing in the morning)

• Sleep disturbances which may include:

  • periodic limb movement of sleep (PLMS)
  • restless legs syndrome
  • sleepwalking
  • tooth grinding

Associated Symptoms of Fibromyalgia

Some people with fibromyalgia develop additional symptoms that are associated with the syndrome which may include:

• Headaches
• Hypersensitivity to cold temperatures
• Loss of grip strength in the hands
• Irritable bowel syndrome
• Chronic pelvic pain
• Cognitive dysfunction (deficits in short-term memory and/or attention)
• Mood disorders (e.g., depression; anxiety)
• Premenstrual syndrome
• Temporomandibular joint (TMJ) dysfunction
• Irritable bladder symptoms (female urethral syndrome)
• Low exercise tolerance
• Myofascial pain syndrome
• Multiple chemical sensitivity
• Chronic low back pain