In fibromyalgia, generalized, widespread muscular pain and tender points may be present. Pain is generally felt all over, although it may start in one region, such as the neck and shoulders, and seems to spread over a period of time. Fibromyalgia pain has been described in a variety of ways including: burning, radiating, gnawing, sore, stiff, and aching. It often varies according to time of the day, activity level, weather, sleep patterns, and stress levels. Most people with fibromyalgia say that some degree of pain is always present. They sense that the pain is mainly in their muscles and often note that fibromyalgia feels like a persistent flu.

About 90 percent of people with fibromyalgia describe moderate or severe fatigue with lack of energy, decreased exercise endurance, or the kind of exhaustion felt with the flu or with lack of sleep. Often the fatigue is more of a problem and more troubling than the pain. Generally, people with fibromyalgia wake up feeling tired, even after sleeping throughout the night. They may be aware that their sleep has become lighter and that they wake up during the night. Scientific studies have demonstrated that most people with fibromyalgia have an abnormal sleep pattern, especially an interruption in their deep sleep.

The fatigue in fibromyalgia is similar to that in another condition called chronic fatigue syndrome (CFS). Some people with fibromyalgia have symptoms of CFS, and vice versa. For example, many people with CFS have the tender points and symptoms considered to be diagnostic of fibromyalgia.

Changes in mood and thinking are common in fibromyalgia. Many individuals feel "blue" or "down," although only about 25 percent are truly depressed at the time of diagnosis, many people with fibromyalgia have a personal history of depression or anxiety at some time in their life. Mood disorders share many similar symptoms with fibromyalgia and vice versa.

There is evidence that some people with fibromyalgia have a history of abuse or neglect during their life as well. It is not clear yet what role these issues might play in the development and continuation of fibromyalgia but these are important things to discuss with your health care provider since addressing such issues may help reduce the symptoms of fibromyalgia and help the person affected cope with the illness.

As with other chronic illnesses, people with fibromyalgia may report difficulty concentrating or performing simple mental tasks. There is no evidence that these problems become more serious. Similar problems have been noted in many people with sleep disturbances of all kinds or with mood changes.

People with fibromyalgia may have feelings of numbness and tingling in their hands, arms, feet, legs, or sometimes in their face. These feelings can suggest other disorders such as carpal tunnel syndrome, neuritis, or even multiple sclerosis. Therefore, people with fibromyalgia often undergo numerous tests for such conditions, only to find that the test results are normal.

Headaches, especially muscular (tension) and migraine headaches, are common in fibromyalgia. Abdominal pain, bloating, and alternating constipation and diarrhea are also common. This may resemble irritable bowel syndrome or "spastic colon." Similar bladder spasms and irritability may cause urinary urgency or frequency.