Fibromyalgia Symptoms: Understanding Pain, Fatigue & More

Fibromyalgia is a chronic centralized pain syndrome. Core features:

Primary Symptoms

• Chronic Widespread Pain: ≥3 months, both sides of body, above/below waist, axial. Deep, aching, burning, or throbbing.
• Profound Fatigue: Unrelieved by rest; "flu-like" exhaustion.
• Non-Restorative Sleep: Difficulty falling/staying asleep; wake unrefreshed. Alpha-delta sleep anomaly.
• Cognitive Dysfunction ("Fibro Fog"): Memory lapses, poor concentration, word-finding difficulty, slowed processing.

Common Comorbidities & Associated Symptoms

• Irritable Bowel Syndrome (IBS)
• Tension headaches / Migraines
• Temporomandibular Joint Disorder (TMJ)
• Raynaud's Phenomenon
• Interstitial Cystitis / Bladder Pain Syndrome
• Dry eyes/mouth (sicca symptoms)
• Restless Legs Syndrome
• Anxiety, Depression
• Post-exertional malaise
• Paresthesias

Diagnosis & Management

Clinical diagnosis (ACR 2016 criteria): widespread pain index + symptom severity, ≥3 months, no other explanation. No definitive lab test.

Multimodal treatment: aerobic exercise, CBT, sleep hygiene, SNRIs (duloxetine, milnacipran), gabapentinoids (pregabalin), low-dose naltrexone, pacing/activity management.