Fibromyalgia is a chronic, or long-term, disorder defined by pain and tenderness throughout your body, accompanied by fatigue. While these are the most common symptoms, fibromyalgia can be accompanied by a wide range of symptoms, some of which are better known than others. Knowing about these rare fibromyalgia symptoms is the first step toward learning how to cope with their effects.
Fibromyalgia Symptoms You Probably Don’t Know About
Heightened Sensitivity to Touch
It’s thought that fibromyalgia disrupts the systems in the brain that are responsible for modulating your experience of pain and that this disruption is responsible for the heightened sensory sensitivities that can accompany the condition.
One way this hypersensitivity can manifest is allodynia, which is when you feel pain from a touch- or temperature-related stimulus that wouldn’t normally be painful.
“Our body has to process all of the information that’s constantly coming in by way of the senses and filter out 99 percent of it,” says Jacob Teitelbaum, MD, the author of From Fatigued to Fantastic. “Separating the signal from the noise, so to speak, takes energy, and energy is precisely what people with fibromyalgia don’t have.”
Experiencing these heightened sensitivities, alone or in combination with one another, can quickly become overwhelming and make day-to-day activities difficult.
How to Cope With Sensory Sensitivities
To start with, it’s important to be very gentle with your body, says Aly Cohen, MD, a fellow of the American College of Rheumatology (ACR) and the founder of Integrative Rheumatology Associates and TheSmartHuman.com health education platform. “I counsel my patients with fibromyalgia or any kind of chronic pain not to push themselves too hard,” Dr. Cohen says. “Learn to say ‘no’ to events and requirements if you can get away with it and give your body an opportunity to rest.”
Sleep is especially important. She adds: “If you don’t get enough sleep, your perception of pain is often elevated regardless of health conditions, but because of the heightened sensitivities that can come with fibromyalgia, it’s especially important to get high-quality sleep, and a lot of it.”
Besides attending to lifestyle factors such as sleep and nutrition, there are treatments you can apply to cope with heightened sensory sensitivities. For instance, medications for fibromyalgia or migraine can also alleviate these symptoms.
Cognitive behavioral therapy (CBT) can be a powerful tool for coping with these symptoms by changing your thoughts and transforming your experiences.
Numbness and Tingling
Paresthesia, or a feeling of “pins and needles” — including tingling, burning and numbness — often accompanies neurological disorders, though the exact cause remains unclear. It is important to speak with a healthcare provider if you experience paresthesia because it could be caused by another condition like small fiber polyneuropathy.
How to Cope With Numbness and Tingling
Attending to your mental and emotional health, such as with meditation, deep breathing, and a mindfulness practice, can help you cope with paresthesia.
“The mind-body connection is very real,” says Cohen. “Go out for a walk in nature, turn off your technology, hang out with friends who make you laugh.”
Physical therapy and gentle exercise can also help, but be cautious. “Only do what is comfortable — if you overdo it, you’ll crash and burn,” warns Teitelbaum.
Headaches and Pain in the Jaw or Face
Fibromyalgia can render you more sensitive to headache triggers, including stress, sleep disruptions, and hypersensitivity to sensory input as described above.
Tension headaches, caused by muscle tension or stress, commonly accompany fibromyalgia. People with fibromyalgia also frequently live with migraine.
Temporomandibular disorders (TMD) — a group of conditions that cause pain and dysfunction in the jaw and surrounding tissues — can also accompany fibromyalgia.
How to Cope With Fibro Headaches
Stress management techniques can prevent or alleviate headaches associated with fibromyalgia. One such technique is progressive muscle relaxation, or PMR, which involves tensing and relaxing your muscles to induce a relaxation response.
For short-term pain relief, Teitelbaum recommends acetaminophen (Tylenol) and creams like Icy Hot or Tiger Balm.
Cognitive Issues (aka ‘Fibro Fog’)
Less rare than the previously mentioned symptoms, brain fog, or “fibro fog” as it is sometimes called, refers to difficulties with thinking and memory that can accompany fibromyalgia. “It’s important to distinguish between brain fog and something like dementia, particularly for elderly people,” Dr. Teitelbaum notes. “Brain fog is forgetting where you left the keys. Dementia is when you forget how to use the keys.”
Like heightened sensitivities, Teitelbaum says it results from trying to manage too much sensory input with too little energy. Cohen adds that there can be a closely linked emotional component: “When we’re overwhelmed, we can have a harder time pulling from memory and performing functional tasks.”
Persistent brain fog can make it difficult to perform work duties or enjoy social activities. Teitelbaum says it's “very treatable.” One treatment he particularly recommends is chewable HRG80 Red Ginseng.
Before relying on medical treatments, Teitelbaum advises attending to lifestyle factors, particularly sleep and nutrition. Strategies for organizing your tasks and time — learning to work at a comfortable pace, and using lists and other techniques to manage your work and life — can also be helpful.
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Rare Fibromyalgia Symptoms
Other lesser-known fibromyalgia symptoms include:
Digestive Symptoms
Stomach pain
Gas, bloating
Constipation, diarrhea
Nausea
Sleep-Disrupting Symptoms
Restless leg syndrome
Insomnia
Medications and Strategies to Help Manage Fibromyalgia Symptoms
Fibromyalgia can cause a vast range of symptoms, many of which overlap with other conditions. But one thing that many of the symptoms above have in common is that they’re related to your gut health.
“Managing gut health is a major aspect of managing fibromyalgia,” Cohen says. “Drink plenty of water, avoid unnecessary medications, eat fiber, and fast occasionally so your gut can rest." Cohen says to also ensure you get enough sodium to prevent postural orthostatic tachycardia syndrome (POTS), a condition in which your heart races when you stand, which is common in people who have fibromyalgia.
Your doctor or psychiatrist might prescribe antidepressants that are specifically approved for fibromyalgia, particularly duloxetine (trade name Cymbalta) or milnacipran (trade name Savella), which can also help relieve some of these rare fibromyalgia symptoms.
Teitelbaum and Cohen both emphasize that proactively managing lifestyle factors, as described above, is the most important step you can take.
The Takeaway
Besides pain and fatigue, fibromyalgia can be accompanied by a wide range of symptoms, including hypersensitivity to sensory input, brain fog, headaches, and digestive symptoms, to name just a few.
A healthy diet, good sleep, good hydration, and a gentle exercise regimen can go a long way toward alleviating or preventing many of these symptoms.
Beth Biggee, MD, is medical director and an integrative rheumatologist at Rheumission, a virtual integrative rheumatology practice for people residing in California and Pennsylvania. This first-of-its-kind company offers whole person autoimmune care by a team of integrative rheumatologists, lifestyle medicine practitioners, autoimmune dietitians, psychologists, and care coordinators.
Dr. Biggee also works as a healthcare wellness consultant for Synergy Wellness Center in Hudson, Massachusetts. Teamed with Synergy, she provides in-person lifestyle medicine and holistic consults, and contributes to employee workplace wellness programs. She has over 20 years of experience in rheumatology and holds board certifications in rheumatology and integrative and lifestyle medicine. Dr. Biggee brings a human-centered approach to wellness rather than focusing solely on diseases.
Dr. Biggee graduated cum laude with a bachelor's degree from Canisius College, and graduated magna cum laude and as valedictorian from SUNY Health Science Center at Syracuse Medical School. She completed her internship and residency in internal medicine at Yale New Haven Hospital, completed her fellowship in rheumatology at Tufts–New England Medical Center, and completed training in integrative rheumatology at the University of Arizona Andrew Weil Center for Integrative Medicine. Following her training, she attained board certification in rheumatology and internal medicine through the American Board of Internal Medicine, attained board certification in integrative medicine through the American Board of Physician Specialties, and attained accreditation as a certified lifestyle medicine physician through the American College of Lifestyle Medicine. She is certified in Helms auricular acupuncture and is currently completing coursework for the Aloha Ayurveda integrative medicine course for physicians.
In prior roles, Dr. Biggee taught as an assistant clinical professor of medicine at Mary Imogene Bassett Hospital (an affiliate of Columbia University). She was also clinical associate of medicine at Tufts University School of Medicine and instructed "introduction to clinical medicine" for medical students at Tufts. She was preceptor for the Lawrence General Hospital Family Medicine Residency.
Dr. Biggee has published in Annals of Rheumatic Diseases, Arthritis in Rheumatism, Current Opinions in Rheumatology, Journal for Musculoskeletal Medicine, Medicine and Health Rhode Island, and Field Guide to Internal Medicine.
Ajai Raj is a reporter specializing in medical science, health, and technology. His work has appeared in Popular Science, Scientific American Mind, The Scientist, and the New York Daily News, as well as a number of medical trade journals.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
Martenson ME et al. A Possible Neural Mechanism for Photosensitivity in Chronic Pain. Pain. April 2016.
He Y et al. Allodynia. StatPearls. September 3, 2023.
Galvez-Sánchez CM et al. Cognitive Impairments in Fibromyalgia Syndrome: Associations With Positive and Negative Affect, Alexithymia, Pain Catastrophizing and Self-Esteem. Frontiers in Psychology. March 22, 2018.
Teitelbaum J et al. An Open-Label, Pilot Trial of HRG80™ Red Ginseng in Chronic Fatigue Syndrome, Fibromyalgia, and Post-Viral Fatigue. Pharmaceuticals (Basel, Switzerland). December 29, 2021.
