We said that the presence of many different symptoms in FM causes it to be confused with many diseases. That’s why these complaints;

Symptoms seen in fibromyalgia;
A) It is seen in every patient,
B) Common,
C) Problems found from time to time
We need to group it into three sections:

A) Symptoms of the disease that are seen in every patient:

a) Common body aches and pains:
Pain and ache occur all over the body, from head to toe, in both the right and left halves of the body, above and below the navel, and around the spine, and this pain is felt deep down, as if it were burning or sprained muscles.

b) Presence of sensitive points:
There are 18 symmetrical sensitive points in various parts of the body. Their locations (pairs) are as follows.
1 – In the occipital region of the head (1-2)
2 – In the front and lower region of the neck (3-4)
3 – In the middle of the trapezius muscle on the back (5-6)
4 – At the shoulder blade protrusion (7-8)
5 – In the forward extension of the 2nd rib (9-10)
6 – On the outside of the elbow (11-12)
7 – Upper and outer side of the thigh (13-14)
8 – On the upper, outer side of the hip (15-16)
9 – On the inner side of the knees (17-18)

In fact, in such chronic FM patients, even smiles, let alone laughter, have disappeared. Frowning eyebrows and sullen faces have become symbols synonymous with FM.

B) Common Disease Symptoms:

1- Fatigue, exhaustion:

It is the most common complaint that occurs to different degrees in almost everyone and can change even during the day and hour. Patients describe this as if my energy is being drained and running out. There are even complaints such as “I feel like concrete blocks are tied to my arms and legs”. There are signs of fatigue that are very difficult to explain, even though they are not working or doing any activity that would make them tired. Fatigue is most noticeable in the morning. These patients almost cannot get out of bed due to fatigue. Fatigue decreases during the day and becomes almost normal towards the evening. In many people with FM, on the contrary, at night, mental activities accelerate and physical capacity increases.Many FM patients become unable to even perform their own professional activities due to this fatigue. For this reason, many of these patients who cannot show the necessary efficiency in their jobs either change jobs or face the fact of being fired from their jobs. In fact, the involuntary toxins of modern life and the deterioration of the mechanisms to resist oxidation, which can be called a kind of rust in the body, and the insufficient intake of vitamins and minerals in the amounts we should take during our diet are another cause of fatigue.

2- Sleep disorders:

These patients are perfectionists and sensitive people. For this reason, they cannot withstand high performance for a long time, and after a while their tempo and therefore their success decrease. After a while, these patients, who are not successful in any job they undertake and are even described as lazy, can, on the contrary, show incredible performance and create wonders while doing a job they enjoy. Then, for the patient who does not feel tired, doing things he enjoys may seem like meditation to him.

We can count the negative factors brought by modern living conditions as the cause of fatigue. The first negatives that can be said are that industrial chimneys and exhaust gases pollute the atmosphere we breathe in, and that many of the things we eat and drink are poisons that will wear out and age the body. On the other hand, excessive consumption of bad carbohydrates, which immediately enter the blood as a result of unconscious nutrition, rapidly increases insulin secretion, and many people become hypoglycemic for this reason. The most important symptom of hypoglycemia is fatigue.

They wake up as if they didn’t get enough sleep, did a heavy job during the night, and couldn’t get any rest. They wake up frequently at night. They fall asleep very easily.
However, in studies conducted in “sleep laboratories”, it has been shown by EEG that these patients cannot go into deep sleep (there is a problem in the rapid eye movement phase (4th phase) of sleep. Grinding of teeth and involuntary arm and leg movements during sleep are quite common.

3. Morning stiffness:

It is a stiffness that begins when getting out of bed in the morning and continues for a long time throughout the body. It is often affected by changes in the humidity of the air. Patients with muscle tension and stiffness can perform any movement they want, albeit with some difficulty.

Some patients describe this morning stiffness as if they drank alcohol the night before and cannot come to their senses even in the morning. In fact, it is common to encounter patients who say, “I cannot recover without drinking 3-4 glasses of strong tea or taking a relaxing hot bath.”

4. Headaches and facial pains:

Headache may be present before the onset of FM. Pain increases with the onset of FM. In most cases, these pains present as migraine or tension-type headache. Stress and worsening daily living conditions cause the muscles that make facial expressions to remain constantly contracted in some FM patients.

These patients, who always have a sullen appearance, have now become almost impossible to smile due to the constant contraction of their facial muscles. It is as if the muscles that enable laughter have already moved away from these functions and have become incapable of laughing.

5. Irritable bowel syndrome (irritable colon):

These patients may have bouts of diarrhea or constipation. Frequent burping or burping and a sudden need to go to the toilet are typical. Despite all the burping, the patient cannot relax, and even after these burps, which are a kind of “air swallowing”, the patient’s problem gets worse. There is constant tension and pain in the abdomen for no reason.

This condition may occur as a reaction to some foods. It is certain that such problems will put FM patients, who are already struggling with other serious problems, into new inextricable predicaments. Sudden stress situations, a food item eaten, changes in season and location may trigger these seizures. There are many FM patients whose complaints like these peak when they eat in a place they are not used to or when they do not sleep in their own bed.

Belching in patients is so disturbing that these people, who burp and burp all day long, avoid being around others for this reason. Gas formation is not always related to the foods eaten. Extreme cold, a food that has a high density or smell and is difficult to digest may cause burping or gas attacks. It is quite remarkable that some of these patients, who feel like a balloon due to the gas accumulated in their abdomen and who need to expel this gas due to the feeling of spasm, burp loudly in a reflex response when the sensitive points on their back are pressed.

In fact, these patients who have massages to relax may experience unpleasant burping when they rub and touch some parts of the muscles. Even worse, some patients may experience major problems during sexual intercourse due to this condition.

These patients, who already feel extreme coldness in their hands and feet, have pain and numbness, and feel constantly tired and exhausted, also have such problems, which further reduces their sexual desire (libido).

The majority of FM patients have marital problems, not only because of these reasons, but also because many things are expected from them and they also have many expectations from their spouses. For this reason, divorces are common.

Such discomforts make treatment for FM extremely difficult. Because if these people who are constantly sick and unhappy, sullen and tense, who are neither at peace themselves nor at peace with others, knew that FM disease lies beneath their tension, they would be able to easily solve many problems that seem to be insurmountable.

6. Numbness and tingling:

Strange sensations that come and go in certain parts of the body, as if insects are crawling on the skin, may occur. Meanwhile, the patient is so disturbed by involuntary movements in their muscles and such strange feelings in their body that they go in and out of the showers, apply ointments and constantly pinch their problem areas in order to get rid of it.

Some people experience muscle twitching or eyelid twitching. Sometimes this situation has increased to the point that even others can easily notice it and has turned into a tic. As FM problems increase, twitching and tics also increase. During periods when he feels well, it may disappear completely or decrease.

7. Intolerance to cold:

Especially hands and feet feel colder than usual. Bruising occurs when exposed to cold, and they even complain that all pain increases with the cold. There are many patients with FM whose daily lives are disrupted with the onset of cold weather. These patients experience unbearable pain and discoloration when their hands come into contact with cold water or a cold object.

His hands are as cold as death, wrinkled, white, and appear to have drained blood. Paleness may turn into bruising after a while. These people, whose hands and feet cannot be warmed even inside the house, have to constantly use gloves and thick socks to survive. During periods when stress intensifies and pain increases, the coldness of the hands increases. When patients feel good, they say their hands are more comfortable. This situation is called “Raynaud’s phenomenon”.

8. Psychological problems:

These patients, who have various degrees of psychological problems, are extremely sensitive to internal and external stimuli. FM is usually seen in people who have high expectations from themselves or their environment. To some extent, it is a disease of patients who cannot cope with stress. Panic attacks, one of the common psychological problems of our age, are also common in patients with FM.

It should not be forgotten that the solution to these psychological problems, which are very difficult to diagnose and treat, can only be achieved through long collaboration with a physician. Constant irritability and sometimes excitement are observed. In fact, it has been observed that all chronic pain patients have difficulties in recognizing and verbally expressing their emotions. In addition, more loss of morale and lack of work force were observed in FM than in other inflammatory rheumatism patients.

A scientist named Goldenberg reported in his study that 46% of 82 FM patients had a history of depression. Another interesting issue is that a history of depression is frequently encountered in the first-degree relatives of patients with FM.

9.Forgetfulness and lack of concentration:

Forgetfulness is a very common complaint in fibromyalgia. There is memory lapse and inability to concentrate on any event. Sometimes they even have difficulty finding words when speaking. He cannot read books or newspapers. Because it has become impossible for him to understand what he reads and keep it in mind. Forgetfulness is sometimes so obvious that they may go out of the house for shopping, fail to remember what to buy, and return home after a while. There are many people with FM who fail in their jobs due to this complaint, which becomes more evident in situations where stress intensifies.

Forgetfulness rather belongs to the recent past. Remote memory is intact. In this way, there is a situation similar to the elderly. He writes notes to avoid forgetting anything, but later he may forget the note he wrote. They have difficulty remembering names, finding directions, or even finding the keys to the house or car.

C) Other problems occasionally found in patients:

1- Restless legs syndrome (RLS):

In 31% of FM patients, restlessness and involuntary movements are observed in the feet while moving or at rest, even when the feet are extended. Patients need to move their legs because they constantly experience burning, pulling, tingling, electrification and numbness. From the moment they put their heads to bed, this problem, the extent of which is barely noticeable during the day, suddenly turns into a major problem that keeps the patient awake. The patient, who knows from past experiences that a sleepless night will begin, is now extremely restless. Likewise, the night of the person you sleep with will not be a good one.

Patients with H.B. Syndrome, who constantly rub their legs in bed, have to get up and walk around after a while, or even have to take a shower, suffer from poor sleep quality and constant fatigue. These people, who involuntarily shake their feet in cinemas, theaters and concerts due to restless leg syndrome, will both feel unhappy and may distract the artist’s attention for this reason.
HBS; It may be an extension of another disease. For example, diabetes, iron deficiency anemia may be due to the use of anti-depressant medications. Additionally, this syndrome may be encountered in patients with kidney disease, patients on dialysis, and people with Parkinson’s disease, after herniated disc operations. This condition can be encountered in people who consume excessive alcohol and even in many women in the 20th week of pregnancy. Hyperactive children may experience RLS pain, which is sometimes confused with growing pains.

In the treatment of restless legs syndrome, people are advised to live a life free from bad habits. Coffee and alcohol should be stopped and regular exercise should be done. Vitamin B12 should be given and iron deficiency, if any, should be corrected. Again, if there is a dopamine deficiency in the body, it will need to be detected and replaced. Patients are recommended to drink plenty of water, alternate hot and cold baths for the legs, and wear comfortable shoes that do not squeeze.

2- Dry mouth and eyes:

Dry mouth is a common symptom of diabetes. Many patients can even understand that their sugar level has increased with this symptom. Here, there are FM patients who suffer from dry mouth, just like in diabetes. Likewise, dry eyes are a symptom of some eye diseases. Similarly, some problems such as dry eyes and stinging and burning in the eyes may occur with FM. These complaints can sometimes disturb patients greatly. (20-35%). Special tear drops for the eyes and chewing gum for the mouth may be recommended.

3- Jaw joint problems:

FM disease may sometimes occur together with a disease called “temporo-mandibular dysfunction syndrome” (25%). There may be problems such as pain while chewing and hearing sounds from the jaw, difficulty in opening the mouth, the problematic jaw shifting to the side when opening, and the head standing forward and forward.

In the treatment of this condition, in addition to the general treatment of FM, methods such as using special mouth appliances for a while, performing some corrective exercises, and special physical therapy procedures are applied.

4- Muscle cramps:

Patients experience atypical cramps in the arms, legs or any other body part, at varying degrees from time to time, sometimes turning into tics. These atypical cramps, which do not occur under normal conditions and in normal places (sometimes in the little finger or on the tip of the nose, etc.), can sometimes make patients suffer hell.

There may be some FM patients who writhe in pain or even scream involuntarily as a result of a sudden contraction out of the blue. It has been observed that these occur more frequently in cold and humid weather, when stress and FM symptoms intensify.

5. Premenstrual tension or painful menstruation:

More tension and painful menstrual periods than normal may occur. This condition, which was not previously present, can often occur after FM begins.

6. Sudden feeling of urination:

As a result of unexpected tension in the bladder, patients feel the need to urinate quickly. Sometimes, unfortunately, urinary incontinence may occur. In fact, the amount of urine produced is extremely little, and sometimes even though it feels like urination is about to be done, the result may not occur. It is inevitable that this symptom, which is considered normal in cases of sudden excitement, becomes permanent and becomes a significant source of distress for an FM patient.

7. Dizziness, hearing loss:

You may experience dizziness for no reason. During the checks, no medical cause or diagnosis of these can be established. Meanwhile, normal pulse and blood pressure are specific to fibromyalgia.

There may also be unexplained hearing loss. Although the hearing tests are completely normal, the inability to hear some high-pitched or low-pitched sounds is one of the problems specific to FM. It is even interesting that some FM patients say that it is as if the people around them are suddenly speaking a different language.

8. Visual disorders:

As a result of the eye muscles being affected by FM, a problem that can be described as a sudden balance shift in vision, also called “visual confusion”, occurs. These patients have problems in driving and reading books. These patients, who suffer from discomfort in brightly lit environments (photophobia), desire to escape from these environments. However, no obvious problems can be detected during eye examinations.

9. Skin findings:

Some unnamed skin problems such as dryness of the skin, color changes in the form of moires, an occasional and sometimes even crazy desire to scratch, and sweating in the fingers may be observed. On the other hand, when sensitive points on the body are pressed, redness of the skin may occur. It takes a long time for these redness to disappear.

10. Chest pain:

Some patients with FM may experience atypical pain in the chest and heart areas. This situation occurs especially in patients who have to work in positions that bend forward or compress the chest.

There may be a stinging sensation when breathing and tightness in the chest. Symptoms that mimic a heart attack with symptoms such as numbness in the hand, pain in the heart area, feeling of faintness, and dizziness are not uncommon in FM. Of course, necessary examinations will be performed on those who apply with such sudden symptoms. But most of the time, all examinations come back normal.

11. Hypermobility syndrome:

It is a disease in which the joints can move much more than normal, and this finding is likely to be seen together with FM disease. It is a disease that does not cause any significant symptoms, in other words does not cause any problems to the patient, and is seen in many people, especially women.

The disease is diagnosed when there is more than normal mobility in 3 or more parts of the body. Symptoms of the disease include the thumb easily approaching the forearm area, the fingers being bent back excessively, the knee or elbow being able to turn back more than normal (10 degrees), the palms being able to touch the ground completely without bending the knees, and the foot being pulled towards itself more than 45 degrees.

12. Excessive increase or decrease in appetite:

In some FM patients, excessive increase or decrease in appetite may occur from time to time for no reason. Patients who are negatively affected by this situation have difficulty gaining and losing weight during periods of appetite. Appetite is often directed towards a single food. This problem is interpreted as an abnormal behavioral feature similar to “interruption” in pregnant women.

13. Various atypical complaints:

There is sweating for no reason, being disturbed by various smells and noises, and sometimes sudden aggravation of existing pain. Some foods, sudden stress, chemicals or even some medications can trigger such symptoms.