The nine most common symptoms of fibromyalgia

You can find the video after the text

In this video, we will talk about the nine most common symptoms of fibromyalgia.

My name is Andreas Persson and I am a physiotherapist and specialist in pain and pain rehabilitation.

Pain
Let’s start with the most defining symptom of fibromyalgia – pain.

Pain in fibromyalgia can be divided into five different pain phenomena.

Reduced pain threshold – This means that people with fibromyalgia get pain more easily, both as a result of touch and through physical load.1-5

Amplified pain – People with fibromyalgia get more pain when they are exposed to something that is painful for anyone.6

Pain at rest – Those with fibromyalgia have pain in the body without it being loaded or stimulated in any way, even when there is no injury or inflammation in the body.7,8

After-pain – People with fibromyalgia easier get after-pain than healthy, normally pain-free people. The after-pain may, for example, come after loading the body in some way, or after being exposed to some type of sensory stimulation such as massage treatment or physical examination by a doctor or physiotherapist.9

Wide spread pain – People with fibromyalgia by definition have pain in large parts of the body.3 Here is a typical pain drawing of where it hurts in a person with fibromyalgia.

Fatigue
Most people with fibromyalgia also suffer from fatigue during the day.7 Fatigue is likely in part caused by the next common symptom. Poor sleep quality.

Insomnia
Nine out of 10 people with fibromyalgia have a sleep disorder.10 The sleep disorder often consists of shallower sleep and of waking up at night and difficulty falling asleep again.

Impaired memory
Studies show that people with fibromyalgia have both impaired working memory and long-term memory.11

Reduced ability to concentrate
In addition to impaired memory, people with fibromyalgia also have impaired ability to concentrate.11

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Numbness
Many people with fibromyalgia experience numbness in different parts of the body. The numbness is due to impaired sensation in the area that is numb.12

Muscle weakness
Many people with fibromyalgia experience decreased strength in the body and that they sometimes suddenly lose strength in different parts of the body, which can manifest itself in that they suddenly drop something, that they fall, or that they do not have the strength to go up a flight of stairs.13

Swelling
About 70% of those with fibromyalgia experience swelling somewhere in the body. The swelling is probably due to neurogenic inflammation.14

Feeling of fever and illness
Many with fibromyalgia experience fever and malaise that often comes after they have done something physically demanding. It is usually not possible to measure fever when measuring body temperature. The fever and malaise are probably due to elevated levels of inflammatory cytokines in the central nervous system.15-17

Comment if you want me to talk more about any of the different symptoms in another film. Like the video and subscribe to the channel if you want to see more similar content.

References

1. Laursen BS, Bajaj P, Olesen AS, Delmar C, Arendt-Nielsen L. Health related quality of life and quantitative pain measurement in females with chronic non-malignant pain. Eur J Pain. 2005;9(3):267-75.
2. King CD, Jastrowski Mano KE, Barnett KA, Pfeiffer M, Ting TV. Pressure Pain Threshold and Anxiety in Adolescent Females With and Without Juvenile Fibromyalgia: A Pilot Study. Clin J Pain. 2017;33(7):620-26.
3. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990;33(2):160-72.
4. Blumenstiel K, Gerhardt A, Rolke R, Bieber C, Tesarz J, Friederich HC, et al. Quantitative Sensory Testing Profiles in Chronic Back Pain Are Distinct From Those in Fibromyalgia. Clin J Pain. 2011;27(8):682-90.
5. Desmeules JA, Cedraschi C, Rapiti E, Baumgartner E, Finckh A, Cohen P, et al. Neurophysiologic evidence for a central sensitization in patients with fibromyalgia. Arthritis Rheum. 2003;48(5):1420-9.
6. Sluka KA, Clauw DJ. Neurobiology of fibromyalgia and chronic widespread pain. Neuroscience. 2016;338:114-29.
7. Hawkins R. Fibromyalgia: A Clinical Update. J Am Osteopath Assoc. 2013;113(9):680-9.
8. Harte SE, Harris RE, Clauw DJ. The neurobiology of central sensitization. J Appl Biobehav Res. 2018;23(2):e12137.
9. Lidbeck J. Centralt störd smärtmodulering vid muskuloskeletal smärta. Läkartidningen. 2007;41.
10. Keskindag B, Karaaziz M. The association between pain and sleep in fibromyalgia. Saudi Med J. 2017;38(5):465-75.
11. Tesio V, Torta DME, Colonna F, Leombruni P, Ghiggia A, Fusaro E, et al. Are Fibromyalgia patients cognitively impaired? Objective and subjective neuropsychological evidence: Cognitive impairment in Fibromyalgia. Arthritis Care Res. 2015;67(1):143-50.
12. Watson NF, Buchwald D, Goldberg J, Noonan C, Ellenbogen EG. Neurologic signs and symptoms in fibromyalgia. Arthritis Rheum. 2009;60(9):2839-44.
13. Góes SM, Leite N, Shay BL, Homann D,Stefanello JMF, Rodacki ALF. Functional capacity, muscle strength and falls in women with fibromyalgia. Clin Biomech. 2012;27(6):578-83.
14. Littlejohn G. Neurogenic neuroinflammation in fibromyalgia and complex regional pain syndrome. Nat Rev Rheumatol. 2015;11(11):639-48.
15. Bjurstrom MF, Giron SE, Griffis CA. Cerebrospinal Fluid Cytokines and Neurotrophic Factors in Human Chronic Pain Populations: A Comprehensive Review. Pain Pract. 2016;16(2):183-203.
16. Bäckryd E, Tanum L, Lind AL, Larsson A, Gordh T. Evidence of both systemic inflammation and neuroinflammation in fibromyalgia patients, as assessed by a multiplex protein panel applied to the cerebrospinal fluid and to plasma. J Pain Res. 2017;10:515-25.
17. Nijs J, Loggia ML, Polli A, Moens M, Huysmans E, Goudman L, et al. Sleep disturbances and severe stress as glial activators: key targets for treating central sensitization in chronic pain patients? Expert Opin Ther Targets. 2017;21(8):817-26.

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