FM-Related Symptoms & Syndromes
In addition to pain and fatigue, a number of symptoms may be experienced with FM. Like pain/fatigue, their severity may wax and wane over time, and individuals may differ in the extent to which they are troubled by them. Possible symptoms include:
Stiffness: Body stiffness is usually most apparent upon awakening, after prolonged periods of sitting or standing, or with changes in barometric pressure.
Sleep Disturbances: Despite sufficient amounts of sleep, FM patients may awaken feeling unrefreshed, as if they have barely slept. Alternatively, they may have trouble falling asleep or staying asleep.
Cognitive Difficulties: These include difficulty concentrating, "spaciness" or "fibro-fog," memory lapses, difficulty thinking of words/names, and feeling overwhelmed when multi-tasking.
Paresthesia: Numbness or tingling, particularly in the hands or feet, sometimes accompanies FM. The sensation, usually called "paresthesia," can also be described as prickling or burning.
Postural Problems: Individuals with FM who engage in activities which involve continuous, forward body posture (i.e., typing, desk work, assembly line work) often have special problems with chest and upper body (thoracic) pain and dysfunction which can, in turn, cause shallow breathing and worsen postural problems.
Sensory Sensitivity/Allergy-like Symptoms: Hyper-sensitivity to light, sound, touch, odors, and ambient temperature frequently occurs among those with FM. Also, it is not uncommon for them to experience reactions to certain substances accompanied by itching, rash, nasal congestion, and sinus pain (non-allergic rhinitis). Dryness of the eyes and mouth (sicca syndrome) can be a problem. They may also feel chilled or cold when others around them are comfortable, or they may feel much warmer than others in the same room.
Difficulty With Balance/Light-Headedness: FM patients may be troubled by vestibular problems for a variety of reasons. Since fibromyalgia is thought to affect the skeletal tracking muscles of the eyes, "visual confusion" and nausea may be experienced when driving a car, reading a book, or visually tracking objects. Alternatively, over-stressed muscles and/or myofascial trigger points in the neck may cause dizziness and unsteadiness. Some FM patients may experience neurally mediated hypotension, a drop in blood pressure and heart rate upon standing, which causes light-headedness, nausea, and "brain fog."
Raynaud's Symptoms: Some FM patients suffer from constriction of the small blood vessels in the hands and feet when they are exposed to cold weather or air conditioning or when they open a freezer. Hands or feet turn cold and white or bluish and eventually other colors like purple or red. Numbness can also occur with pain/discomfort later on as hands or feet re-warm.
Depression & Anxiety: Although FM patients are frequently misdiagnosed with depression or anxiety disorders ("it's all in your head"), research has repeatedly shown that fibromyalgia is not a form of depression or hypochondriasis. Where depression or anxiety do independently co-exist with fibromyalgia or occur as a result of severe FM, treatment is important as both can exacerbate FM and interfere with successful symptom management.
Other Medical Conditions Known To Co-exist Or Overlap With Fibromyalgia
Gastrointestinal Upset: Digestive disturbances, abdominal pain, and bloating are quite common with FM as are constipation and/or diarrhea (or a combination of the two). Together these symptoms are usually known as "irritable bowel syndrome" or IBS. In addition, esophageal dysmotility may be a problem.
Myofascial Pain: A significant number of people with FM have myofascial pain due to trigger points, a neuromuscular condition in which hyper-irritable spots (trigger points) form in taut bands in skeletal muscle or its surrounding fascia, often as a result of injury, prolonged poor posture, illness, or repetitive motion at a work station. These spots are very painful and can refer pain to other parts of the body in very predictable ways and cause limited range of motion, loss of strength and stamina, and a variety of non-pain symptoms. Temporomandibular joint (TMJ) dysfunction, a condition which affects the jaw joints and surrounding muscles and occurs in an estimated one-third to one-half of those with FM, often includes significant myofascial pain.
Chronic Fatigue Syndrome (CFS), also known as chronic fatigue and immune dysfunction syndrome (CFIDS): involves extremely incapacitating fatigue and poor stamina which cannot be accounted for by any other medical condition. Officially, its symptoms, in addition to fatigue, include muscle pain, joint pain, sore throat, tender lymph nodes, problems with short-term memory, difficulty concentrating, headaches, malaise after exertion, and unrestful sleep. Some of these symptoms are similar to those experienced by FM patients.
Genito-Urinary Disorders: FM patients may experience increased frequency of urination or increased urgency to urinate, typically in the absence of a bladder infection (irritable bladder syndrome). Some may develop a chronic, painful inflammatory condition of the bladder wall known as interstitial cystitis. Women with FM may have more painful menstrual periods or experience a worsening of their FM symptoms during this time. Conditions such as vulvodynia, characterized by a painful vulvar region and pain during sexual activity, may also develop.
Restless Leg Syndrome (RLS): A neurologic disorder which involves a "creepy crawly" sensation in the legs and an irresistible urge to move the legs when at rest or when lying down. The syndrome may also involve periodic limb movements during sleep (PLMS) which can be very disruptive to both the patient and the sleeping partner.
FM & Other Rheumatic Conditions: Can FM occur concurrently with other rheumatic conditions? Eminent fibromyalgia researcher, Robert Bennett, M.D., answers this way: "Long-term followup of fibromyalgia patients has shown that it is very unusual for them to develop another rheumatic disease or neurological condition. However, it is quite common for patients with well established rheumatic disease, such as rheumatoid arthritis, systemic lupus, or Sjögren's Syndrome to also have fibromyalgia."
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