Common Fibromyalgia Comorbidities
Photo Credit: gpointstudio /

Hidden Health Concerns That Could Be Complicating Your Condition

Some illnesses tend to occur alongside other illnesses, overlapping their painful sets of symptoms. Fibromyalgia is one of these conditions. In fact, most fibro patients probably struggle with another physical or psychological disorder at the same time — and many don’t even realize it.

Fibromyalgia brings widespread and varied symptoms, so naturally it can be confused for other conditions. Although there is clear fibromyalgia diagnostic criteria, the disease is difficult to measure and nearly impossible to see, so misdiagnosis is still a real problem.

An accurate and complete diagnosis could be the breakthrough you need for good symptom management. In order to get a better diagnosis, you’ll need to know what other conditions might be adding to your pain, and how to spot them.

Common Overlapping Pain Conditions

In many cases, the problem isn’t a misdiagnosis, but rather an inadequate diagnosis. Several conditions are known to overlap with fibromyalgia (which earns them the title of “comorbid” conditions), but they can hide behind fibro symptoms for quite a while. If you’ve been diagnosed with fibromyalgia, be sure to watch out for signs of these overlapping problems.

Chronic Fatigue Syndrome

This is the most common of the fibromyalgia comorbidities. There’s a good deal of similarity between the two diseases — namely, extreme exhaustion and weakness.

In fact, the two conditions can be so similar that experts continue to debate whether or not they are slightly different manifestations of the same underlying condition. According to the Arthritis Foundation, between 50 percent and 70 percent of people with fibromyalgia can also be diagnosed with chronic fatigue syndrome.

However, several elements suggest they are distinct diseases, with separate sets of symptoms that often require different treatment approaches. For instance, chronic fatigue generally brings an inflammatory response (fever and swelling) while fibromyalgia does not, and the predominant fibromyalgia symptom is pain in very specific sites around the body, which isn’t seen in chronic fatigue syndrome.

Headache and Migraine

Over half of fibromyalgia patients complain of frequent headaches or migraines. Studies show that those who suffer with both fibromyalgia and headaches also experience more severe pain and depression than patients with headache alone.

Experts suspect that abnormalities in specific chemical messengers in the brain are to blame for both headache pain and widespread muscle pain (namely, serotonin and epinephrine). In effect, the body responds to stimulation that’s not normally painful with pain sensations.

PMS and Painful Periods

Many women with fibromyalgia can expect longer and more severe stretches of PMS, and heavier, more painful periods. Some of the most common complaints are:

  • Severe cramps
  • Bloating
  • Backache
  • Swollen feet and hands
  • Significant mood swings
  • Headache
You May Also Like

Irritable Bowel Syndrome

The hormonal malfunctions in the brain that come with fibromyalgia could explain why so many sufferers also struggle with digestive issues. Since recent research shows just how closely the brain and the gut are linked, it’s no surprise that abdominal pain, constipation, diarrhea, bloating and chronic nausea — the main elements of irritable bowel syndrome (IBS) — show up so often.

Any syndrome that causes acute pain or stress in the body will almost certainly exacerbate your fibromyalgia, so don’t ignore IBS symptoms. If you notice changes in your bathroom habits or new and uncomfortable bowel sensations that continue for weeks, it’s time to speak with your doctor.

Sleep Disturbances

Sleep disturbances and fibromyalgia go hand-in-hand. Undoubtedly, the pain of fibromyalgia can make it difficult to fall asleep, but the way the pain manifests during the night can also make it nearly impossible to get a restful, rejuvenating sleep.

Some of the most common sleep problems that occur alongside fibromyalgia include:

  • Sleep apnea (when your breathing periodically stops during sleep)
  • Insomnia (the inability to get to sleep and stay asleep)
  • Restless leg syndrome (uncomfortable and uneasy tension in your legs that makes you want to move them around)
  • Periodic limb movement disorder (when muscles involuntarily contract every 30 seconds or so while you’re asleep)

A host of other disorders can come along with fibromyalgia, from nervous system malfunctions (like heart palpitations) to multiple chemical sensitivity, where certain chemicals trigger the familiar pain and fatigue. It can be difficult to differentiate between sets of symptoms and keep track of triggers, but it’s crucial that you try to record any new signs, symptoms or patterns you see, and report them to your doctor.

Psychological Conditions and Fibromyalgia

Physical discomforts are sure to interfere with your daily life, but beware the psychological conditions that can overlap with fibromyalgia, too. It’s easy to dismiss mental or emotional distress as the result of living with chronic pain, but if something more serious is at play, ignoring the issue can cost you dearly.


Unfortunately, depression is incredibly common among fibromyalgia patients — up to 70 percent of fibro patients also have depressive periods, and up to a third will experience major depression. Many experts agree that the same central nervous system and neurochemical problems are present in both conditions.

However, depression and fibromyalgia are two separate conditions, and it’s important to separately diagnose each one for better treatment. Although both conditions alter the pain pathways in the brain, neuroimaging shows that the patterns of altered pain processing are different in depression and fibromyalgia. In turn, different treatment might be necessary to alleviate each problem.


Although major depression is the most common comorbid psychological disorder, some studies found that anxiety disorders aren’t too far behind. Up to 47 percent of fibro sufferers will also struggle with a panic disorder at one point, and up to 60 percent will suffer from another sort of anxiety issue. Panic attacks are severe symptoms, but less intense anxious patterns like chronic worrying or drastic mood swings can point to a big problem, too.

The good news is there are therapies that target both fibromyalgia and psychiatric conditions. Whether your comorbid conditions are physical, psychological or both, the best approach will combine the right medication (often, anti-depressants) with cognitive behavioral therapy (CBT), education and healthy lifestyle changes for a better chance of snuffing out the whole range of distressing symptoms.