Main Features Primary fibromyalgia, without important associated disease, is uncommon compared to concomitant fibromyalgia. It may occur in childhood but is most common in the fourth and fifth decades. Concomitant fibromyalgia occurs with any other musculoskeletal condition, where it may act to intensify the pain of the associated condition. The syndrome is chronic, and remissions are uncommon. Widespread aching of more than three months' duration, often poorly circumscribed and perceived as deep, usually referred to muscle or bony prominences.
Most common areas are cervical, thoracic, and lumbar.
Although pain in the trunk and proximal girdle is aching, distal limb pain is often perceived as associated with swelling, numbness, or stiff feeling. Both pain and stiffness are maximal within the broad sclerotomic and myotomic areas of reference of the lower segments of the cervical and lumbar spine. Tender points are found within muscle and over tendons, muscle insertions, and bony prominences. The predictable location of these tender points and their multiplicity are essential features of the syndrome.