A diagnosis of fibromyalgia is based on patient complaints; unfortunately, no laboratory tests are helpful. Generalized pain is the most prominent feature. Most patients complain of aching and stiffness in areas around the neck, shoulders, upper back, lower back and hip areas. Discomfort may start on one area, then spread to others over time. The pain is often affected by weather conditions, sleep patterns, activity level, and stress. The general physical examination is usually normal, but careful musculoskeletal examination reveals specific localized "tender points." Tender points are usually found on both sides and in the upper and lower portions of the body. The presence and pattern of tender points, in association with widespread pain, distinguish fibromyalgia from other generalized musculoskeletal conditions.
Several complaints may be seen in association with fibromyalgia, including tension and migraine headaches, abdominal pain, bloating, with alternating constipation and diarrhea suggestive of irritable bowel syndrome, as well as bladder spasms and irritability causing urinary urgency or frequency.
Changes in mood and thinking are common in fibromyalgia. Some people may feel anxious and depressed. It is important to remember that people with many chronic illnesses suffer "reactive" depression. People with fibromyalgia may report difficulty concentrating when performing simple mental tasks. Many experience a sleep disorder in which they wake up feeling unrefreshed, even though they may fall asleep without difficulty. Frequent awakenings with a non-restorative quality to the sleep are commonplace. Research has shown that disruption of deep sleep alters many body functions and pain perceptions.
Occasionally, fibromyalgia patients may feel the sensation of numbness and tingling in various body parts, specifically the hands and the feet.
