FIBROMYALGIA (FM) SYMPTOMS
Fibromyalgia (FM) is characterized by the presence of multiple symptoms. The severity
of symptoms can change depending on stress levels, your activity level, the weather, and
other illnesses. There's a link between FM flare-ups and the menstrual cycle. Many
women who suffer from FM report an increase in headaches, body pain, memory problems and
sleep difficulties, in the period leading up to, and during the first half of their
In an article published in PubMed,
"The menstrual cycle and the onset of menopause affect pain and the severity of
other FM-related symptoms in approximately one half of the subjects."
of FM sufferers also are afflicted with
Chronic Fatigue Syndrome. In addition to pain and
fatigue, common symptoms include malaise, headaches, numbness and tingling, dizziness,
sleep disturbance, swollen feeling in tissues, stiffness, sensitivity to noise and
stress, and cognitive impairment.
Muscle & Tissue-Related Symptoms
Sinus & Allergy-Related Symptoms
- Post Nasal Drip
- Runny Nose
- Mold & Yeast Sensitivity
- Shortness of Breath
- Earaches & Itchy Ears
- Ringing Ears (Tinnitus)
- Menstrual Problems
- PMS (as an overlapping condition)
- Loss of Libido
Abdominal & Digestive Symptoms
- Tendency to Cry Easily
- Free-Floating Anxiety (not associated with situation or object)
- Mood Swings
- Unaccountable Irritability
Skin, Hair & Nail-Related Symptoms
- Pronounced Nail Ridges
- Nails that Curve Under
- Mottled Skin
- Bruising or Scaring Easily
- Hair Loss (temporary)
- Tissue Overgrowth (non-cancerous tumors called lipomas,
ingrown hairs, heavy and splitting cuticles, adhesions)
The pain of Fibromyalgia (FM) has no boundaries. It can go from a deep muscular
throbbing pain, to a shooting and stabbing pain, along with a burning sensation - similar
to the feeling of a brush burn of the skin.
Quite often the pain and stiffness is worse in the morning. FM pain affects the
tendons in the body.
Pain can also be felt in the bursa, the sacs that surround your joints providing
nutrition and lubrication needed for movement. Most FM sufferers will experience pain in
all quadrants of the body. Click to Learn The Pain Types.
This symptom can be mild in some people, yet incapacitating for other people. The
fatigue has been described as "brain fatigue" in which patients feel drained of all
Many people depict this situation by saying it feels as if their arms and legs are tied
to concrete blocks. They also report having a difficult time concentrating - referred
to as "fibro fog". One of the most disturbing facts is that this fatigue never seems to
get better, even with extended periods of rest and sleep.
Most FM patients have a sleep disorder called the alpha-EEG anomaly. The alpha-EEG
sleep anomaly was first described by
Hauri and Hawkins, who used
the term alpha-delta sleep to characterize a mixture of alpha and delta waves in a small
group of psychiatric patients described as having "a general feeling of chronic
somatic malaise and fatigue".
Researchers found that most FM patients could fall asleep without much trouble, however,
their deep level (or stage 4 sleep) was constantly interrupted by bursts of wide-awake
brain activity. This leaves sufferers feeling tired and drained. An alarming percentage
of Fibromyalgia sufferers have Alpha EEG Anomaly.
Sleep Apnea -
Sleep Apnea is a sleep disorder characterized by pauses in breathing during sleep.
These episodes, called apneas (literally meaning, "without breath"), last long enough so
one or more breaths are missed, and occur repeatedly throughout sleep. Sleep apnea
is diagnosed with an overnight sleep test called polysomnogram.
Clinically significant levels of sleep apnea are
defined as 5 events of any type or greater per hour of sleep time (from the
polysomnogram). There are two distinct forms of sleep apnea: Central and Obstructive.
Breathing is interrupted by the lack of effort in Central Sleep Apnea. In Obstructive
Sleep Apnea, breathing is interrupted by a physical block to airflow despite effort. In
Mixed Sleep Apnea, there is a transition from central to obstructive features during the
Regardless of type, the individual with sleep apnea is rarely aware of having
difficulty breathing, even upon awakening. Sleep apnea is recognized as a problem by
others witnessing the individual during episodes or is suspected because of its effects
on the body. Symptoms may be present for years, even decades without identification,
during which time the sufferer may become conditioned to the daytime sleepiness and
fatigue associated with significant levels of sleep disturbance. The definitive diagnosis
of sleep apnea is made by polysomnography. 80% of people with FM suffer from sleep apnea.
Obstructive sleep apnea (OSA) is not only much more frequent than Central Sleep Apnea, it
is a common condition in many parts of the world. If studied carefully in a sleep lab
by polysomnography, approximately 1 in 5 American adults has at least mild OSA. Since
the muscle tone of the body ordinarily relaxes during sleep, and since, at the level of
the throat, the human airway is composed of walls of soft tissue, which can collapse, it
is easy to understand why breathing can be obstructed during sleep - particularly in
the obese. Although many individuals experience episodes of obstructive sleep apnea at
some point in life, a much smaller percentage of people are afflicted with chronic
severe obstructive sleep apnea.
Normal sleep/wakefulness in adults has been given 6 distinct stages, numbered 1-4
and including REM sleep (Stage 5) and Wake. The deeper stages (3-4) are required for
the physically restorative effects of sleep and in pre-adolescents are the focus of
release for human growth hormone. Stages 2 and REM, which combined are 70% of an
average person's total sleep time, are more associated with mental recovery and
maintenance. During REM sleep in particular, muscle tone of the throat and neck, as well
as the vast majority of all skeletal muscles, is almost completely weakened, allowing
the tongue and soft palate/oropharynx to relax, and in the case of sleep apnea, to impede
the flow of air to a degree ranging from light snoring to complete collapse. In the
cases where airflow is reduced to a degree where blood oxygen levels fall, or the
physical exertion to breathe is too great, neurological mechanisms trigger a
sudden interruption of sleep, called a neurological arousal. These arousals may or may
not result in complete awakening, but can have a significant negative effect on
the restorative quality of sleep. In significant cases of obstructive sleep apnea,
one consequence is sleep deprivation due to the repetitive disruption and recovery of
sleep activity. This sleep interruption in stages 3 and 4 (also collectively called
Slow-Wave Sleep), can interfere with normal growth patterns, healing, and immune
response, especially in children and young adults.
Common Signs and Symptoms
(The signs and symptoms that follow apply to both adults and children suffering with
Additional signs of obstructive sleep apnea include restless sleep, and loud snoring
(with periods of silence followed by gasps). Other symptoms are non-specific:
morning headaches, trouble concentrating, irritability, forgetfulness, mood or
behavior changes, decreased sex drive, increased heart rate, anxiety, depression,
increased frequency of urination, bed wetting, esophageal reflux and heavy sweating
The most serious consequence of obstructive sleep apnea is to the heart. In severe
and prolonged cases, there are increases in pulmonary pressures that are transmitted
to the right side of the heart. This can result in a severe form of congestive heart
failure (cor pulmonale).
Bruxism or teeth grinding, frequently affects people with FM. Bruxism is thought to be a
part of a disease that is closely related to FM, called Temporomandibular Joint
This disorder causes muscle pain in the face, neck, shoulders, and back, and often
leads to grinding of the teeth. 75% of people with FM also have TMJD. Bruxism usually
occurs when you are sleeping. For some reason, sufferers begin to clench the muscles in
their face causing their teeth to grind together.
Often, bruxism occurs during sleep; even during short naps. In a typical case, the
canines and incisors are commonly moved against each other laterally, i.e. with a side to
side action. This abrades tooth enamel, removing the sharp biting surfaces and flattening
the edges of the teeth. Sometimes, there is a tendency to grind the molars together,
which can be loud enough to wake a sleeping partner. Some will clench without significant
side to side jaw movement. Bruxism is one of the most common sleep disorders.
Thirty to forty
million Americans grind their teeth on a nightly basis. Given enough time, dental
damage will usually occur. Bruxism is the number one cause of occlusal disease and
a significant cause of tooth loss.
Over time, bruxing shortens and blunts the teeth being ground, and may lead to pain in
the joint of the jaw, the temporomandibular joint, or headache. Most people are not aware
of their bruxism and only five to ten percent will develop symptoms such as jaw pain
and headache. Teeth hollowed by previous decay (caries) may collapse; the pressure
exerted by bruxism on the teeth is extraordinarily high.
A recently introduced device called the BiteStrip enables at-home overnight testing for
Sleep Bruxism and might help diagnose bruxism before damage appears on the teeth. The
device is a miniature electromyograph machine that senses jaw muscle activity while
the patient sleeps. A dentist can establish the frequency of bruxing, which helps in
choosing a treatment plan. Anyone having major occlusal rehabilitation should be aware
that bruxism can and does ruin dental work.
Restless Leg Syndrome (RLS)
Many people with FM suffer from Restless Leg Syndrome (RLS) symptoms. RLS causes
unpleasant sensations in the lower limbs, so much so that the limbs have to be moved
in order to reduce the pain.
RLS occurs mostly at night, between the hours of 10:00 pm and 4:00 am, although it can
occur throughout the day in severe cases. It is thought that somewhere between 20% and
40% of FM sufferers also have RLS.
The sensations are unusual and unlike other common sensations, and those with RLS have a
hard time describing them. People use words such as: uncomfortable, antsy,
electrical, creeping, painful, itching, pins and needles, pulling, creepy-crawly, ants
inside the legs, and many others. The sensation and the urge can occur in any body part;
the most cited location is legs, followed by arms. Some people have little or no
sensation, yet still have a strong urge to move.
Any type of inactivity involving sitting or lying - reading a book, a plane ride,
watching TV or a movie, taking a nap - can trigger the sensations and urge to move. This
depends on several factors: the severity of the person's RLS, the degree of restfulness,
the duration of the inactivity, etc.
About 10 percent of adults in North America and Europe may experience RLS symptoms,
according to the National
Sleep Foundation, which reports that "lower prevalence has been found in India, Japan
and Singapore," indicating that ethnic factors, including diet, may play a role in
the prevalence of this syndrome.
Medications for RLS:
The medications most commonly prescribed for restless legs syndrome are dopaminergic
agents, benzodiazepines, opioids, and anticonvulsants. For people whose symptoms come
and go, medications are taken only when the symptoms are a problem.
The class of drugs known as dopaminergic agents are normally the first choice for RLS.
These drugs are approved mainly to treat Parkinson's disease; they alter the activity
of dopamine, a chemical that carries messages in the central nervous system.
However, ropinorole (brand name Requip®) has also been
approved by the Food and Drug Administration for moderate to severe RLS.
Other dopaminergic drugs that may be given, although the Food and Drug Administration
has not approved them for use in RLS, include levodopa plus carbidopa
(Sinemet®), pergolide (Permax - Taken off the
U.S. market March 29, 2007 because of the risk of serious damage to patients' heart
valves.), and pramipexole (Mirapex®). Side effects include
dizziness, drowsiness, nausea, and vomiting. Augmentation, in which symptoms appear
earlier in the day, is a problem with long-term use of these drugs. The solution to this
problem is usually switching to another drug.
Benzodiazepines are a widely used group of sedatives, often prescribed for insomnia.
They work by depressing the central nervous system. This group includes such drugs
as diazepam (Valium),
temazepam (Restoril®), and
clonazepam (Klonopin®). A common side
effect from these sedatives is sleepiness lasting into the next day.
Opioids such as codeine and
oxycodone (OxyContin®) may also be given
for RLS. These drugs relieve pain and cause relaxation. Side effects include nausea,
dizziness, and constipation. If these drugs are used long term, addiction can be problem.
Some doctors may recommend anticonvulsants such as
(Tegretol®) or gabapentin (Neurontin®) to ease the
creepy-crawly feelings of RLS. Side effects include dizziness and drowsiness.
If you have FM you may have noticed that you often feel intense pain in your ribcage
and chest. This aching and stabbing pain is very common in FM and can really impact on
your enjoyment of life. If your chest pains are making it difficult for you to complete
your work, get a good night's sleep, or even breathe deeply, it is important to visit
with your health care provider.
Chest pain in Fibromyalgia is usually nothing to worry about, but occasionally it can
indicate other problems. The chest pain associated with FM is referred to as
costochondritis. Costochondritis is
an inflammation of the cartilage that connects a rib to the breastbone (sternum). It
causes sharp pain in the costosternal joint - where your ribs and breastbone are joined
by rubbery cartilage. Pain caused by costochondritis may mimic that of a heart attack or
other heart conditions.
Costochondritis is the most common cause of chest pain originating in the chest wall.
It occurs most often in women and people over age 40. However, costochondritis can
affect anyone, including infants and children. About 50-80% of FM patients are affected
Your doctor might refer to costochondritis by other names, including chest wall
pain, costosternal syndrome and costosternal chondrodynia. When the pain
of costochondritis is accompanied by swelling it's referred to as Tietze's syndrome.
Most cases of costochondritis have no apparent cause, and most go away on their own.
This makes it difficult to treat. When there's no obvious cause, treatment is aimed at
easing your pain while you wait for costochondritis to resolve on its own.
Costochondritis causes pain and tenderness in the places where your ribs attach to
your breastbone (costosternal joints). Often the pain is sharp, though it can also feel
like a dull, gnawing pain. Pain associated with costochondritis occurs most often on the
left side of your breastbone, though it can occur on either side of your chest.
Other signs and symptoms of costochondritis may include:
- Pain when taking deep breaths
- Pain when coughing
- Difficulty breathing
Doctors don't know what causes most cases of costochondritis. Only some cases
of costochondritis have a clear cause. Those causes include:
Injury. A blow to the chest could cause costochondritis.
Infection. Infection can develop in the costosternal joint, causing pain.
Fibromyalgia. Recurring costochondritis could be a symptom of fibromyalgia. People
with fibromyalgia often have several tender spots. The upper part of the breastbone
is a common tender spot.
Pain from other areas of your body. Pain signals can sometimes be misinterpreted by
your brain, causing pain in places far away from where the problem occurs. Your doctor
might refer to this as "referred pain." Pain in your chest can sometimes be caused
by problems with the bones in your spine compressing the nerves.
Costochondritis pain is often mistaken for heart attack pain. The pain of a heart attack
is often more widespread, while costochondritis pain is focused on a small area. Heart
attack pain usually feels as though it's coming from under your breastbone,
while costochondritis pain seems to come from the breastbone itself. Heart attack pain
may worsen with physical activity or stress, while the pain of costochondritis
Don't waste time, though, trying to distinguish between the two if you're
experiencing unexplained and persistent chest pain. Chest pain is an emergency -
seek medical attention right away.
Many causes of headache have been described in the medical literature over the years.
In 1988, the
International Headache Society published a long, detailed classification of
headache, which has proved helpful for research purposes because it has led to
more reproducible and reliable studies in the field of headache. This classification
was recently revised and updated. For practical clinical purposes, however, all
headaches can be classified as one of the primary headache syndromes or as a headache
that is caused by or secondary to an underlying disease process or condition. Up to
70% of people with FM tend to suffer from the following types of headaches.
Muscle Tension Headaches -
Tension-type headache is characterized by generalized pressure or a sensation of
tightness in the head. (FM patients have 6 tender points in this location) The discomfort
level is usually mild to moderate and does not worsen with activity. Although nausea and
photophobia or phonophobia may occur, they generally are not prominent features.
Tension-type headache can be episodic (less than 15 days a month) or chronic (more than
15 days a month).
Some patients with tension-type headache will exhibit evidence of increased muscle
tension with prominent scalp tenderness, muscle tenderness in the temporomandibular
joint muscles, and/or tight, tender cervical and trapezius muscles. Poor posture is
often evident, which may play a role in causing tension-type headache. If no evidence
of increased pericranial or cervical muscle tightness (no tenderness or limitation of
motion in the neck) is seen during clinical examination, this suggests that the
pain originates centrally.
Learn more about Tension Headaches here.
Migraine Headaches -
Migraine headaches are caused by constrictions of your blood vessels and arteries, and
are thus also known as vascular headaches. Due to stress, fatigue, or illness, the
blood vessels in your head and neck begin to constrict and then dilate, causing severe
pain, nausea, dizziness, and eye pain. A migraine headache can also move around your
head, shifting from side to side.
The common migraine is usually preceded by episodes of anxiety, depression, and fatigue.
The less common type of migraine is the "classic" migraine, and is always
immediately preceded by visual symptoms including double vision, blurry vision,
flashing dots, bright lights, or distorted vision.
These visual symptoms are often called the migraine aura. Sufferers of the "classic"
migraine may experience these symptoms for 15 to 60 minutes immediately before a
migraine. Migraine symptoms typically last about 4 hours, though they can plague you
for as long as a week. Migraines can develop also into chronic headaches.
There are a number of similarities between migraine and FM. Both diseases appear to
involve an exquisite sensitization to stimuli, both are pain syndromes, and depression
and anxiety are common in both. Although migraine is chiefly thought of as headache,
recent reports indicate that increased sensitization in the periphery is common as
well - almost half of migraine sufferers suffer from allodynia (a painful response to
normal stimuli) and about 40% display widespread tender points. A
recent study found
that about 15% of migraine sufferers fit the criteria for FM.
This study found that almost half of FM patients suffered from migraine and 80% suffered
from severe headaches. Most intriguingly a finding that headache preceded FM symptoms
in almost half of the FM patients suggests that sensitization began in the brain and
later spread to periphery. Other studies have found an increased incidence of another
pain disease possibly allied with FM, irritable bowel syndrome (IBS), in
Learn More About Migraines
Cluster Headaches -
Cluster headache causes intense pain that is generally steady and boring behind one eye.
The pain may spread to the temple, face, and even back into the upper neck. It is so
intense that most sufferers will pace the floor or do vigorous exercises during the
attack. The attacks are short (usually less than 3 hours in duration) and often last
only 30 to 45 minutes.
They occur from one to several times a day for a period of several weeks or months,
then remit, leaving the patient pain free for several months or years, only to recur.
During a cluster headache cycle, the attacks of pain often occur at the same time each
day, most often waking the patient in the early morning hours.
of cluster sufferers experience unilateral tearing, with conjunctival injection
and ipsilateral nasal congestion. Alcohol will bring on an attack within a few minutes
in a patient who is in a cluster headache cycle, but it will not induce an attack when
the patient is in remission.
Learn more about Cluster headaches here.
Chronic Daily Headache -
Daily headache may occur as a chronic tension-type headache, but is often a combination
of tension-type and migraine (as often seen in headache clinics). This type of
combination headache does not appear in the current IHS (International Headache
Society) classification, but will be added in the revised version to be published in
2003 or 2004. Most often, this type of combination or "mixed" headache occurs in
an individual who initially had typical episodic migraine but in whom develops, over
several years time, a chronic daily or almost daily headache.
Migraine attacks will occur in addition to the daily headache. Many times, this
daily headache seems to develop because of the frequent use of analgesics, especially
those combined with caffeine and/or butalbital. A daily or near-daily migraine headache
may occur from the frequent use of ergotamine tartrate or any of the triptan drugs.
This headache pattern has been called rebound headache or medication overuse headache.
Secondary Headaches -
Secondary headache may be caused by many different diseases. However,
neurological symptoms and signs are almost always present before there is
significant headache in patients who have a mass lesion in the brain.
arteritis generally occurs in persons older than 50 years and may be associated
with any type of headache. Pain usually is not throbbing and, although it is usually
situated in the temples, can be non localized. Fatigue and a low-grade fever are
often present. The erythrocyte sedimentation rate is high-usually above 60. Diagnosis
is confirmed by a temporal artery biopsy, which typically shows giant cell
inflammation. treatment should begin with 60 mg to 80 mg of prednisone per day as
soon as the diagnosis is suspected, even before the confirmation by biopsy. A
study suggests that methotrexate may be effective in allowing treatment with a lower
dose of steroids.6 If not treated, 20% to 30% of patients with this disease will have
partial or complete visual loss in the affected eye. Therefore, prompt treatment
Aneurysms do not cause recurring headache unless compressing a cranial nerve. They
present with a severe pain at the time of rupture. Occasionally, an
arteriovenous malformation will mimic migraine, particularly if located in the
occipital lobe, but these lesions are more apt to cause seizures or bleed. Headaches
with a postural component need to be evaluated to exclude a lesion in the posterior
fossa. Currently, an MRI scan is the best tool to evaluate the posterior area of the
brain. Pericranial inflammation such as sinus infection, ear infection, or dental
disease is evident on examination and usually of a more recent, acute onset.
Systemic conditions such as endocrine disorders, anemia, sepsis, and hypertension
can present as a non localized headache, but more often will exacerbate an underlying
migraine or tension-type headache.
Temporomandibular Joint Dysfunction
Temporomandibular Joint Dysfunction, commonly referred to as TMD or TMJ, is a
musculoskeletal disorder that is associated with pain from the neck to the head.
The temporomandibular joint connects your jaw to the side of your head. When it
works well, it enables you to talk, chew and yawn. For people with TMJ
dysfunction, problems with the joint and muscles around it may cause
- Pain that travels through the face, jaw or neck
- Stiff jaw muscles
- Limited movement or locking of the jaw
- Painful clicking or popping in the jaw
- A change in the way the upper and lower teeth fit together
Jaw pain may go away with little or no treatment. treatment may include simple things
you can do yourself, such as eating soft foods or applying ice packs. It may also
include pain medicines or devices to insert in your mouth. In rare cases, you might
Generally, the definitive diagnosis is made by a dentist after ruling out other
possible causes like arthritis, infection, tumors or other infrequent
possibilities. Surprisingly, the root cause of this problem often stems from trauma,
a physical injury to that area of the body. The trauma can be a direct blow to the head
or face, an indirect blow like a whiplash injury, or a micro trauma such as clenching
or grinding the teeth repeatedly when under emotional stress. Sometimes the pain may
not start for several months or even years after the initial injury. Other times it may
be a succession of individual traumas, until one finally initiates the dysfunction and
pain. TMD can be the source of complaints of headaches, earaches, facial pain, jaw
clicking and popping, locked jaw, neck and shoulder pain, or even dizziness. The trauma
leads to injury or spasms in the muscles used for chewing food and the neck muscles,
and possibly additional injury to the tissues within the joints.
There are several ways in which psychological factors may play a role in TMD. Sometimes
when people are under too much stress, they clench or grind their teeth together, or
tense their muscles, knowingly or unknowingly, and cause injuries to themselves. Other
times, muscle tension caused by emotional stress, prevents a physically injured area
from healing which results in continuing pain. Still other times, people who have
had repeated treatment failures cannot trust their doctors and don't cooperate with
the treatment plan. This prevents themselves from getting proper help. Whatever the cause
of the pain, having pain causes changes in one's behavior, feelings and thoughts. It
can damage every aspect of one's life.
When the suffering is so great as to cause disability, it is best to work with a team
of professionals who will work with you to regain full functioning. A team may include
a dentist, psychologist, physical therapist, neurologist and other specialists.
One of the simplest and most common procedures for treating some of the psychological
aspects of this disorder is stress management. While the entire topic is too broad for
this article, specific techniques for TMD have been developed and can be tried by
anyone. Stress management may prove useful to you if you have found any of the
- pain that gets worse with stress or tension
- certain people or situations make the pain worse
- work or family pressures are made more difficult because of the pain
- you find that the pain frequently makes you irritable
- you feel nearly out of control, with no idea how to cope with the pain
- others perceive you as being "stressed out"
Mitral Valve Prolapse (MVP)
Mitral valve prolapse is a common heart disorder. It occurs when the valve between
your heart's left upper chamber (left atrium) and the left lower chamber (left
ventricle) doesn't close properly. When the left ventricle contracts, the valve's
leaflets bulge (prolapse) upward or back into the atrium. Mitral valve prolapse
sometimes leads to blood leaking backward into the left atrium, a condition called
mitral valve regurgitation.
Mitral valve prolapse affects slightly more than
2 percent of adults in
the United States. Men and women appear to develop MVP in similar numbers. In most
people, mitral valve prolapse is harmless and doesn't require treatment or changes
in lifestyle. It also doesn't shorten your life expectancy. In some people with mitral
valve prolapse, however, the progression of the disease requires treatment.
Although mitral valve prolapse is a lifelong disorder, many people with this condition
never have symptoms. When diagnosed, people may be surprised to learn that they have a
heart abnormality. When signs and symptoms do occur with mitral valve prolapse,
it's typically because blood is leaking backward through the valve (regurgitation).
Symptoms can vary widely from one person to another. They tend to be mild, develop
gradually and may include:
- A racing or irregular heartbeat (arrhythmia)
- Dizziness, lightheadedness
Chest pain that's not associated with a heart attack or coronary artery disease
Difficulty breathing or shortness of breath, often when lying flat or during physical,
Irritable Bowel Syndrome
Irritable bowel syndrome is a disorder characterized most commonly by cramping,
abdominal pain, bloating, constipation, and diarrhea. IBS causes a great deal of
discomfort and distress, but it does not permanently harm the intestines and does not
lead to a serious disease, such as cancer. Most people can control their symptoms with
diet, stress management, and prescribed medications. For some people, however, IBS can
be disabling. They may be unable to work, attend social events, or even travel
As many as 20 percent of the adult population, or one in five Americans, (4-70% of
FM patients), have symptoms of IBS, making it one of the most common disorders diagnosed
by doctors. It occurs more often in women than in men, and it begins before the age of 35
in about 50 percent of people.
Abdominal pain, bloating, and discomfort are the main symptoms of IBS. However, symptoms
can vary from person to person. Some people have constipation, which means
hard, difficult-to-pass, or infrequent bowel movements. Often these people report
straining and cramping when trying to have a bowel movement but cannot eliminate any
stool, or they are able to eliminate only a small amount. If they are able to have a
bowel movement, there may be mucus in it, which is a fluid that moistens and protect
passages in the digestive system. Some people with IBS experience diarrhea, which
is frequent, loose, watery, stools. People with diarrhea frequently feel an urgent
and uncontrollable need to have a bowel movement. Other people with IBS alternate
between constipation and diarrhea. Sometimes people find that their symptoms subside
for a few months and then return, while others report a constant worsening of symptoms
Researchers have yet
to discover any specific cause for IBS. One theory is that people who suffer from IBS
have a colon (large bowel) that is particularly sensitive and reactive to certain foods
and stress. The immune system, which fights infection, may also be involved.
Normal motility, or movement, may not be present in a colon of a person who has IBS.
It can be spasmodic or can even stop working temporarily. Spasms are sudden strong
muscle contractions that come and go.
The lining of the colon called the epithelium, which is affected by the immune and
nervous systems, regulates the flow of fluids in and out of the colon. In IBS, the
epithelium appears to work properly. However, when the contents inside the colon move
too quickly, the colon looses its ability to absorb fluids. The result is too much
fluid in the stool. In other people, the movement inside the colon is too slow, which
causes extra fluid to be absorbed. As a result, a person develops constipation.
A person's colon may respond strongly to stimuli such as certain foods or stress that
would not bother most people.
Recent research has reported that serotonin is linked with normal gastrointestinal
(GI) functioning. Serotonin is a neurotransmitter, or chemical, that delivers messages
from one part of your body to another. Ninety-five percent of the serotonin in your body
is located in the GI tract, and the other 5 percent is found in the brain. Cells that
line the inside of the bowel work as transporters and carry the serotonin out of the
GI tract. People with IBS, however, have diminished receptor activity, causing
abnormal levels of serotonin to exist in the GI tract. As a result, people with
IBS experience problems with bowel movement, motility, and sensation-having more
sensitive pain receptors in their GI tract.
Vision problems can often accompany Fibromyalgia (FM). FM leads to changes in
eyesight because it impacts the nervous system, which is the center of sensitivity in
the body. When a person develops FM, usually harmless objects can produce pain
and sensitivity. FM sufferers can for example develop sensitivity to stimuli such
as fluorescent lights or to the light produced by a television set.
Contact lenses can cause pain and irritation, while wearing glasses can trigger
Myofascial trigger points in the face and the neck. Pain can also be experienced in the
ears, teeth and nose. FM can also lead to the production of a thick secretion,
which subsequently impacts vision. Night driving can be dangerous for those with FM, as
they often have trouble seeing the lights of oncoming cars.
Urinary and pelvic complaints are common symptoms in 70% of FM patients, particularly in
women with the disease. Bladder
urinary frequency, and painful sexual intercourse are just a few of the urinary disorders
and pelvic symptoms that FM can cause.
If you have Fibromyalgia and think that your symptoms may indicate a problem with your
urinary tract or pelvic area, consult with your doctor. Your pain and discomfort can
be minimized, helping you to live a more active and fulfilling life.
Acid Reflux Disease
Also known as Gastroesophogeal Disease (GERD), this illness occurs in up to 70% of
FM patients. GERD is caused when the opening between the esophagus and the stomach
becomes looser or relaxes at the wrong times.
Normally, this opening allows food to travel only from your esophagus to your stomach.
A muscular valve, called a sphincter, normally keeps stomach contents, including stomach
acid, in the stomach. When the sphincter becomes loose, or relaxes at the wrong
times, stomach contents can flow up from the stomach into the esophagus. This irritates
the lining of the esophagus and over time, this lining is eaten away.
Nausea can arise for a variety of reasons: anxiety, fear, fatigue, or stress. Sometimes
nausea can cause vomiting, and sometimes it will pass without any further symptoms.
Between 40% and 70% of FM sufferers report symptoms of both chronic nausea and vomiting.
These symptoms can vary in intensity, with many only experiencing mild to moderate
nausea. However, some FM patients have to deal with constant nausea that can last for
weeks, or even occur on a daily basis. Such intense nausea can really
other symptoms of fibromyalgia and prevent sufferers from continuing on with their
It is important for such severe nausea to be diagnosed by a health care professional,
to prevent further complications and poor quality of life.
If you suffer from FM you should be especially careful about the amount of stress you
are experiencing. Stress plays a big role in triggering FM symptoms. Episodes
of emotional stress and anxiety can bring on muscle pain and headaches, or even
cause anxiety attacks. Even external stressors, such as loud noises or bright lights,
can trigger FM symptoms.
No one is really sure why FM sufferers react so badly to stress. It may be because stress
can cause our bodies to release certain hormones. These hormones can interfere with pain
perception in FM sufferers.
Others believe that stress increases muscle tension and soreness. In order to keep your
FM symptoms in check, work to limit the stress in your life. Take regular breaks from
work and home life, and reduce your workload. Practice meditation and regular exercise to
help deal with excess energy or stressful situations.
Up to 70% of FM patients are affected by sensory sensitivity. Hypersensitivity to
light, noise, touch, odors, as well as heat and cold.
Allergic-type symptoms (i.e., rhinitis, itching, rash, etc.) may also occur along
with sensitivity to various foods, medications, and weather changes.
Sensation Of Swelling
60% of FM patients report a sensation of swelling in the feet and hands, without
actual swelling present.
Anxiety is very common amongst those who have been diagnosed with FM. It often
occurs in the months following diagnosis, and is thought to affect as many as 70%
of FM patients.
Anxiety is thought to be the result of chemical changes in the body. Special chemicals
found inside of the brain are responsible for governing mood and stress levels. Known as
these chemicals (like serotonin) help
to send messages to different receptors in the brain.
These receptors than change the way we perceive and react to a situation. When levels
of these neurotransmitters aren't balanced properly, it can cause the body to experience
feelings of anxiety. Researchers aren't sure why FM patients suffer so much from
anxiety, but it may have something to do with low levels of serotonin in the brain.
Many FM sufferers have low serotonin levels, and this could be responsible for the
pain, depression, and anxiety that come along with FM.
More About Anxiety
FM is a very painful and frustrating illness to have. FM symptoms like chronic
headaches, sleep disorders, and muscle aches and pains can make living with the
illness difficult and tiresome. Lack of understanding from the medical community,
as well as friends & family members, can also make many FM sufferers feel isolated
As a result, many people with FM experience chronic depression alongside their
illness. Depression can leave you feeling alone, anxious, and extremely sad, and
can make FM even more troublesome to deal with. It is important to recognize the
symptoms of depression so that you can seek appropriate treatment from your health
You are not alone - help for depression is out there and can include support
groups, prescription medications and botanical supplements.
Have you forgotten where you put your keys again? Having trouble remembering what you
were supposed to do this afternoon? Do you have difficulty finding the right words to
use to express yourself? If you are experiencing some or all of these memory problems
you may be suffering from cognitive impairments, also known as "fibro-fog".
Fibro-fog can be one of the most stressful and upsetting FM symptoms. If you know someone
with FM or if you are suffering from the illness, keep an eye out for the indicators
of fibro-fog. These symptoms tend to descend in a haze or "fog," around the
sufferer. Fibro-fogs can occur at any time and can vary in intensity when they do occur.
Fibro-fogs tend to be at their most severe during flare ups in pain. Inability
to concentrate, inability to remember, feelings of brain fog, difficult time
expressing yourself with words, these are all symptoms of fibro-fog.
FM often causes weight gain in individuals due to a number of factors that are both
directly and indirectly related to the disease itself. FM leads to hormonal
imbalances, affecting levels of
and insulin, as well as the production of growth hormones.
Because of this hormonal imbalance, metabolism slows down and weight gain often
follows. Fatigue associated with FM also leads to increased weight. Because FM initiates
an arousal disturbance in the brain wave pattern during sleep, the individual can't get
enough quality sleep; the individual can also suffer from sleep apnea and restless legs,
which increase tiredness.
A new study found that a lack of sleep also leads to higher
production, which is important in sleep and appetite levels. When hypocretin neuron
levels are high (due to environmental and mental stressors), they lead to an increased
state of arousal, leading not only to fatigue, but also to overeating.
Drugs taken to treat FM-related depression can also cause the individual to gain
weight. Antidepressants like Prozac and Zoloft increase appetite, fluid retention, and
can affect hormone levels and therefore metabolism.
Paresthesia is a sensation of tingling, pricking, or numbness of a person's skin with
no apparent long-term physical effect, more generally known as the feeling of pins and
needles or of a limb being "asleep". Numbness or tingling, particularly in the hands or
feet, sometimes accompanies FM.
FM patients may be troubled by light-headedness and/or balance problems for a variety
of reasons. Since FM 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 otherwise tracking objects. Alternatively, weak muscles and/or trigger points in the
neck or TMJ dysfunction may cause dizziness or Disequilibrium. Researchers at Johns
Hopkins Medical Center have also shown that some FM patients have a condition known
as neurally mediated hypotension which causes a drop in blood pressure and heart rate
upon standing with resulting light-headedness, nausea, and difficulty thinking clearly.
You May Also Like...
- Fibromyalgia Symptoms, Fibromyalgia-Symptoms.org.
- Common symptoms of fibromyalgia and chronic fatigue syndrome, Fibromyalgia Network,
P.O. Box 31750, Tucson, AZ 85751.
- National Institutes of Health. National Institute of Arthritis and Musculoskeletal
and Skin Diseases (NIAMS). Frissora C., "Symptom overlap and comorbidity of irritable
bowel syndrome with other conditions." Current Gastroenterol Reports, August 2005.
Issue 7(4, pp 264-71.
- Offenbaecher M,; Ackenheil M., "Current trends in neuropathic pain treatments with
special reference to fibromyalgia." CNS Spectrum, April 2005, issue 10(4), pp 285-97.
- Patten S.; et al, "Long-term medical conditions and major depression: strength
of association for specific conditions in the general population." Canadian Journal
of Psychiatry, March 2005, vol. 50(4), pp 195-202.
- Temporomandibular Joint Dysfunction, U.S. National Library of Medicine, MedlinePlus.
- Nampiaparampil D.; Shmerling R.; "A review of fibromyalgia." American Journal of
Managed Care, November 2004, vol. 10(11 Pt 1), pp 794-800.