The overwhelming characteristic of fibromyalgia is long-standing, body-wide pain with defined tender points. Tender points are distinct from trigger points seen in other pain syndromes. Unlike tender points, trigger points can occur in isolation and represent a source of radiating pain, even in the absence of direct pressure.

Fibromyalgia pain can mimic the pain that occurs with various types of arthritis. However, the significant swelling, destruction, and deformity of joints seen in diseases such as rheumatoid arthritis does not occur with fibromyalgia syndrome alone.

The soft-tissue pain of fibromyalgia is described as deep-aching, radiating, gnawing, shooting or burning, and ranges from mild to severe. Fibromyalgia sufferers tend to wake up with body aches and stiffness.

For some patients, pain improves during the day and increases again during the evening, though many patients with fibromyalgia have day-long, unrelenting pain. Pain can increase with activity, cold or damp weather, anxiety, and stress.

Specific symptoms:

• Multiple tender areas (muscle and joint pain) on the back of the neck, shoulders, sternum, lower back, hips, shins, elbows, knees.
• Fatigue
• Sleep disturbances
• Body aches
• Reduced exercise tolerance
• Chronic facial muscle pain or aching

Diagnosis of fibromyalgia requires a history of a least three months of widespread pain, and pain and tenderness in at least 11 of 18 tender-point sites. These tender-point sites include fibrous tissue or muscles of the:

• Neck
• Shoulders
• Chest
• Rib cage
• Lower back
• Thighs
• Knees
• Arms (elbows)
• Buttocks

Sometimes, laboratory and x-ray tests are done to help confirm the diagnosis. The tests will also rule out other conditions that may have similar symptoms.

A number of tests may be done to rule out other disorders. Chronic fatigue syndrome, irritable bowel syndrome, and rheumatoid arthritis may also be present. New patients should be checked for these underlying conditions as well as fibromyalgia.