Widespread musculoskeletal pain – The chief complaint of a patient with fibromyalgia is widespread musculoskeletal pain which is bilateral and involves both upper and lower parts of the body. The pain may be localized initially, commonly in the neck and shoulders. The predominant description of the pain is muscle pain, but the patients may complain of joint pain as well. 
Fatigue – The other cardinal symptom of fibromyalgia is fatigue.  Especially when waking up from sleep, but is also in the mid-afternoon. Minor activities may aggravate the pain and fatigue, though inactivity for a prolonged period also increases the symptoms. There is stiffness on waking up in the morning. Patients complain of sleeping lightly with frequent awakenings during the early morning. They feel unrefreshed in the morning even if they complete 8 to 10 hours of sleep.
Cognitive disturbances – Often referenced as “fibro fog,”; patients have difficulty with attention and doing tasks that require rapid changes in thought.
Other symptoms – 30 to 50 percent of patients have anxiety and/or depression at the time of diagnosis.  More than 50 percent of the patients have headaches which include migraines and tension types. Patients often complain of paresthesias, particularly in both arms and legs. A detailed neurologic evaluation is usually unremarkable. Among gastrointestinal syndrome, IBS commonly correlates with fibromyalgia. Gastroesophageal reflux disease (GERD) occurs more commonly in patients with fibromyalgia compared to the general population. Patients may complain of dry eyes, dyspnea, dysphagia, and palpitations.
- Generalized stiffness, especially when wake up in the morning.
- Sensation of inflammation and tingling, poorly defined in the hands and feet.
- 90% of patients are tired.
- 70-80% suffer of sleep disorders.
- Up to 25% suffers anxiety or depression.
- Fibrofog (confusion, memory problems).
- And among others; headaches, menstrual cramps, irritable colon, dry mouth and eyes.
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6 Wang JC, Sung FC, Men M, Wang KA, Lin CL, Kao CH. Bidirectional association between fibromyalgia and gastroesophageal reflux disease: two population-based retrospective cohort analysis. Pain. 2017 Oct;158(10):1971-1978. https://pubmed.ncbi.nlm.nih.gov/28683023/