The age factor, especially in women, is extremely important. Approximately 50 percent of the patients remember a specific triggering event associated with an abrupt onset of symptoms. These events more often include physical or emotional trauma or an illness or a virus syndrome. The pain may begin in a localized area, often in the neck and shoulders, and then spread over a period of time to other parts. In more than 80 percent of patients, the neck and shoulders, mid and lower back are involved, and eventually complaint of weakness after minimal activity or exercise.
Profound fatigue is especially part of the diagnosis with frequent arousals during the night.
Gastrointestinal symptoms or irritable bowel syndrome are reported in 50 to 80 percent of the patients. Muscular or tension headaches are common. Some patients report a history of migraine headaches. These patients characteristically consult many physicians without much benefit. Many of them find their way to the acupuncturist with little or no relief.