Fibromyalgia is associated with a wide range of symptoms. Most studies report that these symptoms can be remarkably persistent and pervasive over the years, sometimes remaining as long as 15 years after onset. Most symptoms, however, do tend to improve over time.

Symptoms are typically worse during cold or damp weather, periods of emotional stress and at the beginning and end of the day. They may be aggravated by poor sleep, physical and mental fatigue, excessive physical activity or inactivity, anxiety or stress. Signs and symptoms include:

• Multiple tender points (trigger points). The presence of multiple tender points, usually at muscle-tendon junctions, is a major characteristic of fibromyalgia. These points are more susceptible to pain than the rest of the body.
  
  
• Chronic, widespread pain. Another major characteristic of fibromyalgia is tender skin and an overall reduction in pain threshold. The pain is most often within the muscles (myalgia). It may be confined to specific areas (e.g., neck, shoulders) early in the course of the disorder but usually spreads to other muscle groups over time (e.g., back, arms, legs, chest). This pain is often described as deep muscular aching, throbbing, twitching, stabbing and/or shooting pain. It may be accompanied by soreness, stiffness, numbness, tingling, burning and/or a crawling sensation. Though varying in intensity, some degree of muscle pain is always present. Pain behaviors such as limping, grimacing, or guarded movements and postures, may be easily noticeable and impair quality of life.
  
  
• Muscle stiffness. This is usually present upon awakening and tends to improve over time, but may remain throughout the day. Often, the joints feel swollen, although inflammation is not present.
  
  
• Fatigue. A general, all-encompassing exhaustion exists in the vast majority of fibromyalgia patients. Specific muscle fatigability and weakness is also increased. This fatigue tends to interfere with daily activities and may leave the individual with a limited ability to function, mentally and physically.
  
  
• Sleep problems. Includes disorders that prevent deep, restful, restorative sleep. An individual may have difficulties falling asleep or may be awakened repeatedly during the night. Other individuals may get a full night’s sleep, but awaken feeling unrefreshed and exhausted. Specific sleep problems, including sleep apnea (repeated episodes where an individual temporarily stops breathing) and bursts of awake-like brain activity that interrupts deep sleep may be observed.
  
  
• Headaches. More than half of all patients who have fibromyalgia report migraines and other headaches.
  
  
• Impaired cognitive function (“fibro fog”). Includes memory failure, poor working memory (ability to hold something in mind while using it for another mental process) and impairments in concentration, coordination and vocabulary retention. Research indicates that these individuals perform as poorly as healthy individuals 20 to 30 years their senior, although they retain a speed of mental processing roughly equal to healthy individuals their age.
  
  
• Hypersensitivity (increased sensitivity). Many fibromyalgia patients report heightened sensitivity to temperature, odors, sounds, lights and vibration. They also suffer from increased skin sensitivity.
  
  
• Mood disturbances. Irritability, depression and anxiety are common symptoms of fibromyalgia. Depressed individuals may not be aware of or deny their depression, which can complicate the treatment of fibromyalgia. The presence of these symptoms may be due to many factors, including:
  
  
• Prolonged pre-diagnosis period
• Disrespectful medical treatment
• Grief and loss common to any chronic illness
• Poor support
• Sleep deprivation
• Other coexisting chronic health conditions
• Severe chronic pain
• Neurotransmitter abnormalities
  
  
• Difficulty in sustaining repetitive motor tasks. Many fibromyalgia patients report trouble performing repetitive activities such as typing because of increased pain and fatigue.
  
  
• Reduced physical efficiency. Decreased physical efficiency, due to a longer time required to accomplish tasks, is common.
  
  
• Variations in alertness. Many fibromyalgia patients report a diurnal (daytime) variation in energy levels and alertness and describe a window of opportunity at which they are at their best that typically extends from about 10 a.m. to 2 p.m.
  
  
• Other symptoms, including:
  
  
• Dry eyes and mouth
• Rashes
• Excessive menstrual pain
• Ringing in the ears (tinnitus) and ear pain
• Painful intercourse
• Dizziness
• Vision problems
• Low-grade fever
• Below-normal temperature