Early Signs of Fibromyalgia: A Complete guide
Early Signs of Fibromyalgia: What is Fibromyalgia?The term “myalgia” refers to pain in a muscle or group of muscles. Thus, Fibromyalgia is a chronic widespread pain condition of the muscles, tendons, and ligaments. It is the most common source of chronic pain for women ages 20 to 55. There is no cure, but medications are helpful in controlling the symptoms. Professionals have determined that Fibromyalgia impacts the nervous system. According to the American College of Rheumatology, Fibromyalgia is not an autoimmune condition or an inflammatory disease process like arthritis because it does not result in damage to the muscles or the joints. However, it is often secondary to a primary inflammation-driven illness such as lupus, or rheumatoid arthritis, and patients can have inflammation-like symptoms.
Types of Pain Associated With Early Signs of FibromyalgiaBecause fibromyalgia affects the nervous system, symptoms are thought to be related to heightened pain sensations. The body’s nerve endings send incorrect electrical signals to the brain. With nerves in overdrive, what is typically a non-painful stimulus (i.e. a slight touch) causes significant pain. An amplified pain response exceeds the basic ache. Fibromyalgia leads to numerous types of pain:
- Sensations of Hot or Cold
Early Signs of Fibromyalgia: Common Fibromyalgia Pain LocationsFibromyalgia pain is displayed in numerous locations in the body. While the condition results in painful muscles, discomfort can span from head to toe. Areas with the most pronounced pain differ from patient to patient. The main diagnostic tool for Fibromyalgia is the tender point exam, which entails a medical professional pressing down on 18 symmetrical “pain points.” Those early in the diagnostic process frequently complain of deep muscle pain in the legs and hips, but some experience pain throughout the entire body at once. Common locations of Fibromyalgia pain include:
- Front and Back of Neck
Early Fibromyalgia Symptoms: PhysicalContrary to what the general public assumes, Fibromyalgia is a multi-system illness. The effects are not confined to the chronic, widespread muscular pain. Patients with Fibromyalgia actually have a host of symptoms in multiple organ systems.
Early signs of Fibromyalgia: Interstitial Cystitis (IC)Also named painful bladder syndrome, patients with Fibromyalgia are prone to developing interstitial cystitis (IC). IC affects the urinary system—the bladder and kidneys. The kidneys produce urine. That waste is stored in the bladder until the brain sends a message to the nerves signaling that the bladder is full. In a normal functioning urinary system, nerve signals prompt the release of urine via the urethra (the tube that carries urine from the body) without pain. Communication between the nerves and the brain is interrupted by interstitial cystitis. It is no wonder that Fibromyalgia and interstitial cystitis are related, as the chronic pain of Fibromyalgia is thought to be from incorrect nerve signals too. The bladder symptoms are extensive.
Early signs of Fibromyalgia: Urgent and Frequent UrinationPatients with Fibromyalgia and IC feel the need to urinate from only small amounts of urine in the bladder. Although the bladder is hardly considered full, the discomfort felt is comparable to holding urine all day long—simply from the nerve miscommunication. Frequent and urgent urination is a symptom of both conditions, especially as patients seek to reduce the sensations of urgency. The Urology Care Foundation states, “the average person urinates no more than 7 times a day [and] he or she does not have to get up at night more than once to use the bathroom.” But, frequency and urgency caused by IC ensues both day and night.
Early signs of Fibromyalgia: Pain and Pressure of BladderLike the other forms of Fibromyalgia pain, the pain caused by interstitial cystitis can be migratory and intermittent. The pelvis, urethra, lower back, behind the vagina in women, and the scrotum in men are the typical locations of IC pain. From my personal experience with the condition, the pain is similar to a urinary tract infection with the burning accompanied by an intense pressure.
Early signs of Fibromyalgia: Glomerulations (Bleeding)Interstitial cystitis is chronic inflammation of the bladder. Irritation of the bladder can cause damage. Inflammation over a period of time can result in ulcers and glomerulations, which are pinpoint hemorrhages of the bladder wall that may cause bleeding. 95% of patients with IC experience glomerulations. The tiny hemorrhages are not-life threatening, but the minute amounts of bleeding are occasionally startling to those unaware of the possibility.
Early signs of Fibromyalgia: TriggersDiet and lifestyle factors are not the underlying reason for IC, but diet and lifestyle choices have a huge influence on interstitial cystitis. Acid foods, foods with artificial sweeteners, spices, and caffeinated beverages are the main triggers. Sex is also painful and exacerbates symptoms. Learning your triggers is key to pain management.
Early signs of Fibromyalgia: GastrointestinalDigestive problems are prevalent amongst those with Fibromyalgia. Patients undergo comprehensive testing to get to the root of their digestive ailments, yet rarely is an abnormality identified. Regardless of its acceptance in medical literature, the connection is not completely understood. Doctors believe that since overactive pain receptors are the culprit of Fibromyalgia pain, receptors throughout the gastrointestinal tract are similarly hypersensitive. Gastrointestinal Symptoms:
- Abdominal Pain
Early signs of Fibromyalgia: Irritable Bowel Syndrome (IBS)Stomach woes that come and go are commonplace for patients with fibromyalgia. If GI symptoms increase in frequency, it could suggest a secondary disorder known as Irritable Bowel Syndrome (IBS). Irritable Bowel Syndrome and Fibromyalgia are functional disorders. Functional disorders are clinically diagnosed by symptom presentation because there is no testing to confirm the diagnosis. Whereas fibromyalgia is characterized by hypersensitivity of the muscles, the hypersensitivity in IBS stems from the intestine. Symptoms are persistent and identical to the ones listed above—alternating diarrhea and constipation, abdominal pain, gas, bloating, etc.
Early signs of Fibromyalgia: Sleep DisordersWe all yearn for a peaceful repose when under the weather. A problem for Fibromyalgia patients is that they feel unwell the majority of the time, but their symptoms prevent them from quality sleep. Studies show that three quarters of those with Fibromyalgia suffer from a sleep disorder. Fibromyalgia interferes with the brain’s sleep signal, causing one to have reduced slow wave sleep. Slow wave sleep is the deepest form of rest.
Early signs of Fibromyalgia: InsomniaJokingly called “painsomnia,” Fibromyalgia patients struggle with insomnia. Insomnia is a sleep disorder defined as the inability to fall and stay asleep. Pain is a contributing factor to insomnia. Despite already having difficulties falling asleep, patients awake intermittently throughout the night due to pain. Many are diagnosed with restless leg syndrome along with insomnia, as Fibromyalgia patients toss and turn because of the need to move their legs to find the least painful sleeping position.
Early signs of Fibromyalgia: Sleep ApneaFibromyalgia impedes normal breathing patterns during sleep. Those with fibromylagia experience pauses in breathing attributable to sleep apnea. Loud snoring, daytime fatigue, irritability, morning headaches, dry mouth, and gasping for air while asleep are sleep apnea symptoms that fibromyalgia patients may notice if they also have apnea. Clinical and Experimental Rheumatology found that upper airway resistance syndrome, a variant of sleep apnea where the upper airway narrows, is common in women with Fibromyalgia. This has profound repercussions on quality of rest.
Early signs of Fibromyalgia: FatigueDwindling energy levels are par for the course with Fibromyalgia. Insomnia and sleep apnea do not help, as the body is working diligently to function and it cannot acquire proper rest. The current theory about the relationship between fibromyalgia and fatigue is that because the nerves are constantly sending inappropriate signals, the body grows tired. Fatigue is so considerable in fibromyalgia that chronic fatigue syndrome is an overlapping diagnosis.
Early signs of Fibromyalgia: NeurologicalAs previously explained, fibromyalgia originates from the nervous system. The nerves of a fibromyalgia patient are in a constant state of misfiring. The brain conveys improper signals to the organ systems and vice versa. Basically, the body does not get the memo for ideal functioning. It is no surprise that the hyperactivity of the nervous system seen in fibromyalgia causes a plethora of neurological symptoms.
Early signs of Fibromyalgia: Noise, Light, and Smell SensitivityLook around you. What do you see, touch, hear, smell? Familiar environments should not be overwhelming. However, basic stimuli overstimulate the senses in those with fibromyalgia. Loud noises, bright lights, and strong smells trigger symptoms ranging from migraines to increased chronic pain. Muscles grow tense following an exposure. Simply shopping at a store with fluorescent lighting is enough to trigger a flare.
Early signs of Fibromyalgia: Allodynia (Touch Sensitivity)The hug from a friend, a pair of jeans in contact with your skin, the slightest contact with the bedsheets—imagine if the slightest touch caused you pain. That is the reality of fibromyalgia. Heightened pain receptors in patients with fibromyalgia lead to allodynia, which is the medical verbiage for touch sensitivity.
Early signs of Fibromyalgia: Temperature SensitivitySunburns throughout childhood are evidence that heat produces pain, as is the burning sensation from grabbing a pile of snow with bare hands. In normal circumstances, extreme temperatures precipitate injury. Those with fibromyalgia have a lower temperature threshold. It takes a less extreme temperature to instigate discomfort. Malfunction of the autonomic nervous system, a condition known as Dysautonomia, is another factor contributing to temperature sensitivity in fibromyalgia. The autonomic nervous system controls all bodily processes that occur automatically. Patients can encounter rapid and drastic temperature changes because the body cannot maintain homeostasis when under stress.
Early signs of Fibromyalgia: NeuropathyFibromyalgia does not result in direct damage to muscles or nerves. Still, the diagnosis of Fibromyalgia leaves one prone to neuropathic conditions like small fiber neuropathy because of secondary health problems. Comparing various subjects, patients with fibromyalgia proved to have a decrease in nerve fibers in their skin and the subjective pain responses consistent with small fiber and peripheral neuropathy. Small fiber nerves in the skin are crucial to autonomic function. If patients with fibromyalgia are suffering from autonomic dysfunction, then neuropathy is a probable outcome. Autonomic symptoms such as orthostatic hypotension, tingling in hands and feet, incontinence, numbness and tingling in the limbs, and muscle weakness are indicative of neuropathy secondary to fibromyalgia.
Early signs of Fibromyalgia: Vision ChangesAnother phenomenon of fibromyalgia’s vast effect on the nervous system is its act on vision. In fibromyalgia, especially early on, patients notice a sporadic decline in vision. These changes manifest subtly. For example, blurred vision while focusing on a subject and difficulties with night driving. Dry eyes and eye pain are vision symptoms correlated with the nervous system signals gone rogue.
Early signs of Fibromyalgia: Lack of Balance/CoordinationApproximately 75 percent of fibromyalgia patients have poor balance and coordination due to dizziness. Symptoms are the worst upon standing, which could be from of autonomic dysfunction prevalent in those with fibromyalgia—Postural Orthostatic Tachycardia Syndrome (POTS). As the body attempts to regulate functions when standing, signals from the nervous system are not reaching the heart. With postural changes, blood pressure drops and heart rate increases to compensate. Dizziness can escalate to episodes of syncope (fainting) and pre-syncope (blackouts). The aftermath is lack of coordination and injury from falls. It prevents daily tasks like cooking, cleaning, shopping, and exercise.
Early signs of Fibromyalgia: Cognitive ProblemsThe infamous “fibro fog” is the source of much grief. Fibromyalgia impairs cognitive function. Patients periodically feel confused—like a thick haze is clouding their thoughts. This encompasses the symptoms of forgetfulness, unclear speech, and insufficient focusing skills. Putting the silverware in the freezer or fumbling for words seems laughable initially, but it is distressing when similar events transpire daily. Medical professionals claim cognitive impairment in fibromyalgia is derived from an overactive nervous system. The body has trouble balancing regular environmental stimuli while also processing increased pain signals. Trouble sleeping and distraction from pain adds to the mental burden.
Early signs of Fibromyalgia: HeadachesWhether from sleepless nights, noise or light sensitivity, or vision changes, headaches are a common symptom. Chronic headaches and migraines are a comorbidity for over 75% of fibromyalgia patients. The attacks of unbearable head pain can trigger full-body flares. It is plausible that patients with migraines have altered brain chemicals, like substance P and serotonin, which are strongly connected to pain sensations and cause migraine symptoms.
Early Fibromyalgia Symptoms: PsychologicalThe number of fibromyalgia patients who are told their illness in their head is unfortunate. With diagnosis based on clinical presentation, patients with fibromyalgia are usually debilitated for years before they receive a name for the symptoms plaguing their body. Fibromyalgia is in your head, but not in the way some think. Psychological symptoms emerge from the physical condition.
Early signs of Fibromyalgia: Depression and AnxietyDepression is distinguished from normal feelings of unhappiness when a sense of worthlessness, guilt, and unexplained sadness persists longer than 2 weeks. Anxiety—the worry and fear surrounding life—is a consequence of depression. Both mental disorders are linked to fibromyalgia. A neurotransmitter imbalance is the primary cause of depression and anxiety in those with Dysautonomia and fibromyalgia, as the body’s fight or flight response is on the fritz. Nevertheless, other aspects of life with fibromyalgia are responsible for mental disorders. Chronic pain is a distressing event. Isolation, fear of the future, and anxiety about symptoms fuels depression.
Early signs of Fibromyalgia: Emotional/Mood SensitivityRapid mood swings arise from fibromyalgia for the same reasons as depression and anxiety. Chemicals in the brain become imbalanced. So, the heightened sensitivity to pain is akin to increased emotional sensitivity. Chronic pain is emotionally taxing. Every person deals with pain in their own manner and that can mean spells of moodiness or sadness over enduring physical symptoms 24/7.
Early Signs of Fibromyalgia: Unusual symptomsAs you have gathered, there is more to fibromyalgia than what meets the eye. Although the symptoms of the invisible illness affect a specific set of main body systems, a combination of unusual manifestations can accompany the condition.
Early signs of Fibromyalgia: SweatingExcessive sweating is a peculiar symptom of fibromyalgia. Profuse sweating is attributable to 4 separate elements of the condition: dysfunction of the autonomic nervous system responsible for sweating, a byproduct of secondary anxiety, medication side effects, and temperature sensitivity.
Early signs of Fibromyalgia: BruisingA constellation of unsightly bruises is classic to fibromyalgia skin. Easy bruising happens from frequent injury after dizzy spells, nutritional deficiencies with rampant GI symptoms, and accidents from sleep deprivation. Practicing good sleep hygiene can eliminate the chance of the latter.
Early signs of Fibromyalgia: SwellingFibromyalgia is deemed a non-inflammatory illness because it does not cause damage to the joints and basic inflammation markers in blood-work are within normal limits, but swelling elsewhere in the body indicates the potential for an inflammatory process. Clinical evidence proves a subset of fibromyalgia patients have an increase in cytokines, which are inflammatory mediators in the immune system. In the absence of inflammation is swelling from fluid retention edema. The puffiness from edema tends to go to the hands, feet, eyes, and forehead area.
Early signs of Fibromyalgia: Muscle TwitchesThe average Joe is familiar with the annoying eyelid twitch deemed a sign of stress or fatigue. That mechanism is intensified in fibromyalgia. Random muscles throughout the body twitch because the nerves are activated without ever receiving signals.
Early signs of Fibromyalgia: Menstrual Pain or ChangesWomen are more likely to develop fibromyalgia than men. Female patients report worsening of their symptoms around their menstrual cycles. Since pain signals are always increased, cramps and other unpleasantness during that time of the month escalate pain levels.
Early signs of Fibromyalgia: AllergiesFood allergies, hay fever, plain ol’ sensitive skin—the allergies of fibromyalgia patients are ever increasing. The Asthma and Allergy Foundation states that an “allergy is an abnormal reaction of the body to an encountered allergen introduced by inhalation, ingestion, injection, or skin contact, often manifested by itchy eyes, runny nose, wheezing, skin rash, or diarrhea.” The role of allergies in fibromyalgia is connected to the immune response. With the body fighting itself, it mistakenly recognizes certain triggers as harmful. Many with fibromyalgia are diagnosed with Mast Cell Activation Syndrome (MCAS). MCAS is a condition where the mast cells (allergy cells) are easily triggered to release chemical mediators (i.e. histamine, cytokines, prostaglandins, etc.). Allergic and non-allergic symptoms result such as chronic bone pain, flushing, fainting, nausea and vomiting, and more. Fibromyalgia is a complicated illness. Science has barely scratched the surface of its effects. With time, my hope is that medical professionals will learn more about how its symptoms impact the human body. Those with fibromyalgia deserve great respect. After all, navigating life with chronic pain is not easy. References Frieri M. Mast Cell Activation Syndrome. Clin Rev Allergy Immunol 2015. [Epub ahead of print]. 10.1007/s12016-015-8487-6. Gracely, R. H., Ceko, M., & Bushnell, M. C. (2011). Fibromyalgia and depression. Pain research and treatment, 2012, 486590. Rodriguez-Pinto I, Agmon-Levin N, Howard A, Shoenfeld Y. Fibromyalgia and cytokines. Immunol Lett 2014;161:200–3.
Cheyanne is currently studying psychology at North Greenville University. As an avid patient advocate living with Ehlers Danlos Syndrome, she is interested in the biological processes that connect physical illness and mental health. In her spare time, she enjoys immersing herself in a good book, creating for her Etsy shop, or writing for her own blog.