Multiple research publications and descriptive efforts have been devoted to improve definition. Interested physicians must link patient complaints and physical findings for diagnosis and exclude mimicking diseases. Today, fibromyalgia is accepted as a distinct illness. Patients present with fatigue, insomnia, non-restorative sleep and generalized pain. Restless legs and cramps are frequent as are brittle nails, skin crawling, burning and itching with or without various rashes.
Symptoms are cyclic, initially followed by normal times but progressively worse, finally constant.
The knees, inner and outer elbow regions, wrists, hips and chest are equally frequent sources of discomfort. However, other sites are so often involved, pain should be expected from any skeletal muscle, tendon, ligament or fascia. Morning, flu-like, generalized stiffness is common. Previously injured or operative sites are often affected. Though accidents and stress aggravate the condition, they do not cause it.