Diagnostic Criteria

In addition to also being recognized as an inflammatory disorder, some research studies have also found that FMS may be an autoimmune-related disorder. Some medical research groups have also found that FMS and Chronic Fatigue Syndrome (CFS) have 75% crossover symptom similarities.

Some published diagnostic studies have suggested that fibromyalgia is better determined when a person experiencing FMS symptoms is found to have at least 11 of the 18 possible tender points that can occur throughout the body. These are areas where pain will occur upon applying mild pressure to them, using a fingertip.

The areas on the body where these tender points may occur include the following:

  • the hips
  • the knees
  • the back of the head near the base of the neck
  • upper areas of the chest
  • the upper back in the cervical spine area
  • the elbows
  • the shoulders

Fatigue and Sleep Disturbances

Fatigue is another major symptom of FMS and it is sometimes exacerbated by sleep disturbances that can also occur. The fatigue is often relentless and proper sleep and rest does little to alleviate it completely. Normal circadian sleep rhythms (cycles) that are supposed to occur become abnormal in fibromyalgia patients, which results in daytime sleepiness and feeling more awake during nighttime hours.


Medical research, including that conducted by the National Institutes of Health (U.S.-NIH), suggests that abnormal functioning of the adrenal glands is one possible cause of the disrupted sleep patterns, due to the adrenal hormone “cortisol” not being properly regulated by the adrenal glands in people who have fibromyalgia.

Digestive Disturbances and IBS

FMS patients may complain of severe indigestion, heartburn and acid reflux with FMS but may also experience alternating spells of constipation and diarrhea. This may indicate that they are also suffering from Irritable Bowel Syndrome (IBS). Frequent gastritis and bloating may also manifest as part of the digestive problems that can occur with fibromyalgia.

Headaches and Sensory Disturbances

Many people with fibromyalgia experience frequent headaches and these may have a neurological aspect to them that they have not experienced previously. The headaches may sometimes have an unusual pattern to them or will affect the person’s senses as they occur (i.e. eyesight, sense of smell, taste and hearing). These sensory changes can occur with headaches or may also occur without them.

These may include heightened and/or loss of sensitivity to the following:

  • light
  • noises
  • flavors
  • odors
  • sense of touch

Emotional and Mental Symptoms

People with FMS may also experience symptoms of anxiety and depression and a change in mental functioning. These emotional symptoms may alternate between those of anxiety and depression or the patient may experience mostly one of these mood problems. A person with fibromyalgia may experience anxiety symptoms as an increase in chronic worry and episodes of fear, including the possibility of panic attacks. The depression may be perceived by them as a profound sadness, an emptiness or hopelessness.

This demonstrates the importance in monitoring fibromyalgia patients for any signs of worsening emotional symptoms, which may require treatment as a separate issue, in addition to treatments that are needed for rheumatic symptoms (muscle pain).

Mental functioning may also become diminished in fibromyalgia patients. They may have difficulty concentrating and will experience what is often referred to as “brain fog,” a term to describe mental dullness or an inability to focus with the same sharpness they had previous to their illness. Short-term memory loss is also experience in some FMS patients.

See Your Doctor

People who experience the symptoms described in the subheadings above need to see a qualified, licensed medial physician in order to confirm a diagnosis of fibromyalgia or other conditions with similar symptoms. Patients receiving a diagnosis of FMS can move forward with appropriate treatment, which can help to control symptoms or diminish them significantly and return them to an improved quality of life. They can also reach out to a digital health platform for guidance and benefits.


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