Symptoms of fibromyalgia

Fibromyalgia is a chronic pain disorder that is accompanied by a variety of symptoms. In addition to fatigue, frequent accompanying symptoms include sleep problems, vegetative symptoms and functional complaints.

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Fibromyalgia, also known as fibromyalgia syndrome or muscle fibre pain, is a chronic pain disorder. As such, pain is a leading symptom of fibromyalgia syndrome.

Pain is basically a warning signal from the body. In fibromyalgia, however, this warning function is out of balance and pain occurs independently of direct triggers. It can manifest itself in different ways and in almost all areas of the body. This article differentiates pain and highlights other symptoms that may occur with fibromyalgia.

What are possible symptoms of fibromyalgia?

Fibromyalgia syndrome (FMS) can be accompanied by various symptoms. Symptoms of FMS include

  • Chronic pain that occurs in at least three areas of the body for at least three months
  • Difficulty falling asleep and staying asleep** or the feeling of not being well-rested in the morning
  • Increased physical and mental exhaustion that cannot be compensated for by sleep (fatigue)

In addition, those affected report

  • vegetative symptoms such as cold hands and feet, dry mouth, heavy sweating, involuntary trembling limbs (tremor)
  • functional symptoms such as sensory disturbances, discomfort, a foreign body sensation in the throat (globus sensation), swelling and stiffness
  • physical complaints such as breathing and heart problems, organic complaints, bladder dysfunction, altered menstruation
  • hypersensitivity to stimuli such as sensitive eyes, sensitivity to noise and odours
  • Mental complaints such as nervousness, inner restlessness, low spirits, loss of drive and depressive mood.

What these symptoms mean in detail and how they manifest themselves is explained below.


Pain is a complex, unpleasant sensory and emotional perception. It fulfils a warning function, as it generally indicates potential or actual tissue damage, injuries or illnesses and is therefore vital for survival.

Pain is a complex phenomenon that can manifest itself physically (e.g. burning, stabbing, pulsating), but can also cause emotional distress (e.g. agonising, exhausting). The perception of pain is individual and is determined by biological, psychological and social factors. These influencing factors are also illustrated in the bio-psycho-social model.

Pain is divided into acute and chronic pain.

Acute pain

Acute pain has an important protective function and usually subsides once the cause has been eliminated.

Chronic pain

Pain is referred to as chronic pain if it lasts longer than 3 months. Chronic pain has lost its original warning function.

Sleep problems

Sleep problems are a variety of conditions that affect the quality and quantity of sleep.

They include difficulty falling asleep, sleeping through the night or waking early, which leads to impairments in everyday life.

Tiredness & exhaustion (fatigue)

Fatigue is a state of extreme exhaustion and tiredness that differs significantly from normal tiredness. In fatigue, the tiredness and lack of energy are not in proportion to the previous activity. Nor can this exhaustion be reduced by normal rest or sleep.

Fatigue can manifest itself through physical exhaustion, but also through cognitive fatigue.

Physical fatigue can be accompanied by symptoms such as

  • Weakness and a feeling of weakness throughout the body,
  • reduced physical performance, which manifests itself in difficulties with everyday activities,
  • heaviness in the limbs, which can lead to pain in the limbs,

manifest itself. Physical fatigue is disproportionate to previous activities.

Cognitive fatigue can manifest itself, for example, in

  • impaired concentration,
  • reduced attention span
  • reduced responsiveness
  • lack of motivation,
  • emotional reactions such as irritability

manifest themselves.

Fatigue differs from normal exhaustion, tiredness or sleepiness as it is more profound and persistent. It is also disproportionate to previous activities and cannot be compensated for by sleep.

Pacing is recommended as a form of energy and activity management to deal with fatigue.

Vegetative symptoms

Fibromyalgia can also be accompanied by vegetative symptoms. Vegetative disorders can occur when the conduction of excitation in the autonomic nervous system is disturbed. The autonomic nervous system is the part of the nervous system that controls the involuntary functions of the body, such as heartbeat, digestion, respiration and metabolism."

As a result, symptoms such as cold hands and feet (acras), dry mouth, heavy sweating (hyperhidrosis), involuntary trembling limbs (tremor) can occur.

Functional complaints

Fibromyalgia can be accompanied by functional symptoms. Functional symptoms describe physical complaints that can affect, for example, the sensory system, voluntary motor skills, pain and digestion.

Fibromyalgia can, for example, cause sensory disturbances and paresthesia.

A sensitivity disorder (paraesthesia) is an unpleasant but usually not painful physical sensation that is not triggered by appropriate stimuli. An example of this is a touch that triggers a tingling sensation.

A dysesthesia is a sensation that does not match the previously triggered stimulus. A stimulus triggers a false sensation, for example when a light touch is perceived as painful. Dysaesthesia is usually a change in the quality of sensation, in which the sensitivity on the surface of the skin is usually affected.

A foreign body sensation can also occur in the throat or neck. One speaks of a globus sensation if this foreign body sensation occurs independently of food intake.

Other accompanying symptoms

Fibromyalgia can also be accompanied by various other symptoms.

These include breathing and heart problems, organic (gastrointestinal) complaints (gastrointestinal), bladder dysfunction or altered menstruation in female patients. Hypersensitivity to stimuli and psychological complaints such as irritability and depressive moods or even depression can also occur.

Fibromyalgia syndrome (FMS) can be accompanied by a variety of different symptoms. However, many of the symptoms are non-specific and can also be triggered by other illnesses.

It is therefore very important to document symptoms accurately and discuss them with the doctor treating you. A first port of call is the family doctor, who can assess the symptoms holistically, taking into account the patient's medical history.

Fibromyalgia is a chronic pain disorder that is accompanied by sleep disorders, fatigue and other symptoms in addition to pain. Fibromyalgia symptoms can occur globally throughout the body. It is therefore important to document symptoms accurately and discuss them with your doctor.

[1] DocCheck. fibromyalgia. Retrieved on 28.06.2024 at

[2] Mayo Clinic. fibromyalgia. Retrieved 28.06.2024 at

[3] NHS. fibromyalgia. Retrieved on 28.06.2024 at

[4] Anne Toussaint: Introduction Somatoform Disorders, Somatic Stress Disorders. 1st edition. Munich 2020, ISBN 978-3-8252-5349-3.