Fibromyalgia – Related Conditions

Published: September 5, 2017
Last reviewed: January 31, 2018

If you have typical symptoms of fibromyalgia, such as widespread body pain and tenderness, fatigue and insomnia, but also others, such as rash, fever, wheezing, nausea or mouth ulcers, you may have an additional condition (see Chart 1) or an entirely different condition.

Certain conditions appear together with fibromyalgia because they are all caused by stress, for example, post-traumatic stress disorder, irritable bowel syndrome, temporomandibular joint disorder, myofascial pain syndrome, migraine and interstitial cystitis [1,8].


Various autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis [10], Hashimoto thyroiditis [16], inflammatory bowel disease [8] and diabetes mellitus [28], also commonly appear together with fibromyalgia.

Often, the relationship between fibromyalgia and other conditions is not clear.

Chart 1. Conditions Related to Fibromyalgia

Arthritis: ankylosing spondylitis, osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus [8] Swollen joints, skin rash, hair loss, swollen lymph nodes
Atypical facial pain [23] Continuous unilateral facial pain
Bipolar disorder [34] Alternating euphoria and depression
Dercum’s disease or adiposis dolorosa [15] Obesity and multiple painful lipomas
Diabetes mellitus [4,28] Burning hands and feet or no symptoms
Endometriosis [10,25] Pelvic pain, menstrual cramps
Functional somatic or affective spectrum disorders [2,3,26,27]
  • Attention-deficit hyperactivity disorder (ADHD): short attention span, impulsiveness
  • Eating disorders (bulimia nervosa): excessive eating followed by vomiting
  • Migraine
  • Obsessive-compulsive disorder (OCD): repetition of words or movements
  • Panic disorder: anxiety, fainting
  • Post-traumatic stress disorder (PTSD): intrusive memories, avoidance of trauma-related places
  • Social phobia
Gastrointestinal disorders
  • Celiac disease and non-celiac gluten sensitivity [12,13]: diarrhea after eating wheat products
  • Gastroesophageal reflux disease (GERD): heartburn
  • Inflammatory bowel disease (Crohn’s disease, ulcerative colitis) [8,10]: abdominal pain, nausea, low-grade fever, mouth ulcers
  • Irritable bowel syndrome (IBS) [5]: constipation or diarrhea after meals, gas pain
  • Small intestinal bacterial overgrowth (SIBO) [22]: abdominal bloating, excessive gas
Genitourinary problems [9,10,11]:

Pain in the bladder, perineum or genitalia, frequent urination
Hashimoto thyroiditis [8,16] Goiter, sensitivity to cold, leg swelling (edema)

  • Mycoplasma infection [19]
  • Hepatitis C [29]
Dry cough, low-grade fever, nausea, jaundice, fatigue
Iron-deficiency anemia [17] Paleness, shortness of breath, exercise intolerance
Mitral valve prolapse [2,18] Fatigue, shortness of breath or no symptoms
Myofascial pain syndrome [20]

Muscle knots with trigger points, pain or decreased ability to open the mouth
Raynaud’s phenomenon [9] Numbness and color changes in fingers triggered by cold
Sick building syndrome with asthma, multiple chemical sensitivities, food allergies and intolerances [1] Cough, difficulty breathing, wheezing, nosebleeds, itch, flu-like symptoms
  • References

      1. Fleming KC et al, 2015, Central Sensitization Syndrome and the Initial Evaluation of a Patient with Fibromyalgia: A Review  PubMed Central
      2. Coplan J et al, 2015, A Novel Anxiety and Affective Spectrum Disorder of Mind and Body—The ALPIM (Anxiety-Laxity-Pain-Immune-Mood) Syndrome: A Preliminary Report  Psychiatry Online
      3. Bradley LA, 2009, Pathophysiology of fibromyalgia  PubMed Central
      4. Ghaly S et al, 2012, Prevalence of Juvenile Fibromyalgia Among Children with Type1 Diabetes Mellitus in Ismailia-Egypt  ScopeMed
      5. Triadafilopoulos G et al, 1991, Bowel dysfunction in fibromyalgia syndrome  PubMed
      6. Wolfe F et al, 2010, Fibromyalgia, Systemic Lupus Erythematosus (SLE) and the Evaluation of SLE Activity PubMed Central
      7. Bennet RM et al 2007, An internet survey of 2,596 people with fibromyalgia  PubMed Central
      8. Yunus MB, 2012, The Prevalence of Fibromyalgia in Other Chronic Pain Conditions  PubMed Central
      9. Bennet R, Clinical features of fibromyalgia
      10. Fibromyalgia facts sheet The Centers of Disease Control and Prevention
      11. Pontari M et al, 2013, New developments in the diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome  PubMed
      12. Isasi C et al, 2014, Fibromyalgia and non-celiac gluten sensitivity: a description with remission of fibromyalgia  PubMed Central
      13. Isasi C et al, 2016, Non-celiac Gluten Sensitivity and Rheumatic Diseases Rheumatología Clínica
      14. Caro XJ et al, 2008, A subset of fibromyalgia patients have findings suggestive of chronic inflammatory demyelinating polyneuropathy and appear to respond to IVIg  PubMed
      15. Hanson E et al, 2012, Review of Dercum’s disease and proposal of diagnostic criteria, diagnostic methods, classification and management  PubMed
      16. Haliloglu S et al, 2017, Fibromyalgia in patients with thyroid autoimmunity: prevalence and relationship with disease activity  PubMed
      17. Pamuk GE et al, 2008, An increased prevalence of fibromyalgia in iron deficiency anemia and thalassemia minor and associated factors  PubMed
      18. Pellegrino MJ et al, 1989, Prevalence of mitral valve prolapse in primary fibromyalgia: a pilot investigation PubMed
      19. Endresen GK, 2003, Mycoplasma blood infection in chronic fatigue and fibromyalgia syndromes  PubMed
      20. Chandola HC et al, 2009, Fibromyalgia and Myofascial Pain Syndrome-A Dilemma  PubMed
      21. Levine TD et al, Routine use of punch biopsy to diagnose small fiber neuropathy in fibromyalgia patients  PubMed Central
      22. Pimentel M et al, 2004, A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing  PubMed Central
      23. Krolczyk SJ, Persistent idiopathic facial pain  Emedicine
      24. Burning mouth syndrome  NIDCR
      25. Endometriosis
      26. Hudson JI et al, 2003, Family study of affective spectrum disorder  PubMed
      27. Barsky AJ et al, 1999, Functional somatic syndromes  PubMed
      28. Tishler M et al, 2003, Fibromyalgia in diabetes mellitus  PubMed
      29. Boomershine CS, Fibromyalgia  Emedicine
      30. Clauw DJ, 2014, Fibromyalgia clinical review  CiteSeerX
      31. Lantos PM et al, Chronic Lyme disease  PubMed Central
      32. Sigal LH et al, 1992, Lyme arthritis as the incorrect diagnosis in pediatric and adolescent fibromyalgia  PubMed
      33. Cassisi G et al, 2011, Chronic widespread pain and fibromyalgia: could there be some relationships with infections and vaccinations?  PubMed
      34. Kudlow PA et al, 2015, Prevalence of fibromyalgia and co-morbid bipolar disorder: A systematic review and meta-analysis PubMed

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