The primary symptoms of fibromyalgia are body-wide pain, non-restorative sleep (fatigue), and cognitive deficit. These symptoms can be present in other painful conditions. Because of this, many experts still believe a thorough physical exam is necessary. Even though the tender point assessment has been challenged because not all patients have the exact same tender point pattern, all fibromyalgia patients complain of tenderness in all four quadrants of the body.
Fibromyalgia shares an important component with other chronic pain disorders called centralization or hypersensitivity, which may be due to the bombardment of pain signals on the brain. What sets fibromyalgia apart is that it also has symptoms that suggest a connection with certain comorbid disorders such as, migraine, restless leg syndrome, myofascial pain syndrome, teeth grinding, bladder and bowel difficulties, etc. While these other conditions should be investigated, ruling them in does not rule out fibromyalgia, it may be a determining factor.