As previously noted, pain is the most dominant chief complaint. Two thirds of patients at times report severe pain. The descriptions used to characterize the pain are inclusive of radiating, shooting, pressing, pricking, and nagging. The areas most affected are the back, neck, shoulders, arms, knees, hands, hips, thighs, legs, and feet. At times the TMJ region and the anterior chest can be affected.
Symptoms are most dominant early in the morning and late a night.
Patients frequently feel tired all the time with an associated sense of weakness throughout multiple muscular parts. Sleep patterns are poor with morning fatigue, frequent awakenings during the night, and difficulty falling asleep. The typical physical examination for patients with fibromyalgia reveals multiple tender points throughout the body, often numbering eleven to eighteen spots. Joints are often tender, and range of motion is often restricted due to pain. Laboratory tests, however, inclusive of blood chemistry, complete blood count, erythrocyte sedimentation rate, and rheumatoid factor are negative.