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Adrienne Dellwo

The Fatigue in Fibromyalgia: Not 'Normal Tiredness'

By September 27, 2010

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Research Brief

The fatigue experienced in fibromyalgia goes beyond "normal tiredness," according to research just published in the journal BMC Musculoskeletal Disorders.

Researchers wanted to further understanding of fatigue in fibromyalgia and the impact it has on our lives. After conducting and analyzing interviews, they formed a conceptual model of our fatigue that includes:

  • An overwhelming feeling of tiredness,
  • That's not relieved by rest or sleep,
  • Not proportional to exertion,
  • Associated with a feeling of weakness/heaviness,
  • Interferes with motivation, desired activities and prolonged tasks,
  • And makes it difficult to concentrate, think clearly, or remember things.

For those of us who live with this kind of fatigue, that's old news. However, in my opinion this model is a good step forward. The medical world doesn't have a good understanding of different fatigue types and needs adequate language to describe them. Everyone gets tired, and fatigue is one of the main complaints doctors hear. This model provides a definition of fibromyalgia-related fatigue that helps distinguish it from other types.

Personally, I've experienced every aspect of fatigue in the model, to varying degrees. I've found that even good doctors often don't understand the weakness we feel because of fatigue. This can be a frightening symptom -- I've been afraid to even walk at times because I felt like my legs were too weak to hold me. It's a weakness that comes and goes, so it's another one of those things that doesn't make sense on the surface. Hopefully this link to fatigue will help us and our doctors understand it better.

Does this new model describe the kind of fatigue you've experienced? Have you noticed other things that seem to be related to fatigue? Leave your comments below!

Learn more or join the conversation!


Photo John Foxx/Getty Images

September 27, 2010 at 7:19 am
(1) Gareth says:

I have trouble vocalising these kinds of things but you’ve done a great job here. I have experienced all of these to varying degrees.

September 27, 2010 at 8:16 am
(2) Nancy A. says:

The above list describes fibromyalgia fatigue very well. If we only had these problems to deal with, it would be bad enough. Now, add constant generalized body pain and all our other symptoms to the fatigue, and the researchers would get a more realistic version of what our lives are really like.

I’ve been suffering with fibromyalgia for 24 years, and it bugs me that medical science is only now starting to take us seriously and working harder to find better treatment and/or a cure for us. I keep hanging in there and pray for that day to come.

September 27, 2010 at 11:07 am
(3) Dana says:

Honestly it feels like the fatigue that comes from being hypothyroid. After a diagnosis of Hashimoto’s thyroiditis blood work indicated that I was fine but I have never felt fine. I’ve tried all forms of thyroid without a return to previous energy levels. In fact I have been getting steadily worse over the past 18 years. Then for the past 5 years I’ve had pain and sensitivity.

September 27, 2010 at 12:21 pm
(4) Cheryl says:

What a timely post….I’m suffering a horrible bout of Fibro fatigue today and feeling guilty about it…it’s Monday morning and I keep telling myself I should be rested enough to get some decent work done…instead I am sitting (reclining really) on the couch with my laptop fighting this horrible heaviness that keeps washing over me and trying to suck me down…my eyes keep closing and I’ll nod off for a few minutes, only to jerk awake again and try to remember what I was working on….thank goodness this is a slow work day and I have no conference calls scheduled….the description above is right on point….and today that fatigue is washing over me in heavy waves….i’d take a nap if I thought it would do me any good….

September 27, 2010 at 3:51 pm
(5) Diane says:

When I went to my doctor last spring regarding the pains I was having I could only describe the problems with my arms as a heaviness. Sometimes my arms feel so heavy and tired, it is difficult to keep them both on the steering wheel. I usually end up steering with one hand at the bottom of the wheel and resting on my legs. Not very safe!

September 27, 2010 at 6:31 pm
(6) ELISABETH says:


September 27, 2010 at 7:14 pm
(7) joann says:

this tiredness is so hard to explain to people who dont have it. I try to tell then it is not like the tiredness you feel after a hard day of labor. It like a magnet that in the ground pulling all your energy out of you and you canT even think straight or move straight. Sometimes it feels like my body wants to just stop functioning! It can be so depressing when you got tons of stuff to do and can not do it.

September 28, 2010 at 8:01 am
(8) sarah says:

The pain and the tiredness is toatlly shut down for me both physical and ven mental task you just cant go on.
I get more confused and say the wrong words headaches ring in my ears and just cant even comuincate x

September 28, 2010 at 5:37 pm
(9) chelsesa says:

This was immensely helpful; I emailed it to my doctor with a note that explained how accurate it was. I’d been trying for weeks to articulate the constant, overwhelming tiredness. Fog head and depression combine to make expressing symptoms very hard. thank you so much for posting. I hope lots of doctors see this.

September 29, 2010 at 12:42 am
(10) Rotem Cohen says:

We have to see to it that we take time to relax ourselves everyday. It does not pay off if we abuse our body because of our intention to get things done all at once.

October 1, 2010 at 8:17 pm
(11) Sophie says:

Long ago, I quit thinking that I was suffering or a victim of firbromyalgia which only brings us down. I am a survivor of fms which helps.

October 1, 2010 at 9:54 pm
(12) Jewel says:

I can certainly relate. One person mentioned being pulled down towards the ground, like gravity. What a wonderful explanation. The only way I have been able to describe this fatigue is to tell people I suddenly feel so weak I think I will just fall over. It’s the oddest thing….I never know when it will happen. I try to be very careful not to over exert. I’ve even fallen a couple of times, but that only happens when I feel weak and a little off balance at the same time. The weakness and the mental fog are the most difficult for me to cope with. I used to be rather bright and I’m not anymore.

October 2, 2010 at 3:58 am
(13) Jane says:

Beautifully written…You’ve described it to a T. I’m going to get my DH to read it as it is the one area of this blooming condition that is so hard to explain. I can’t bear it when I hear…”if you are tired…have a nap”. It just doesn’t work that way. For me it is like having a pot of energy and when it is gone it is GONE..like hitting a brick wall I can’t do anything else until the next day. Some days I get a big pot of energy and other days a little pot…I can’t guess ahead of time what it will be.

October 3, 2010 at 8:24 am
(14) Cindy says:

I have been trying to get some help from my fibro doc for these exact issues, he perscribed Adderall (Riddilin), don’t know if I spelled it right. My family doc says don’t take it, what do you do? I am constantly nodding off at the computer, even if I do take a nap, up and down and tossing and turning at night, have a hard time even brushing my hair at times cause my arms are too weak to hold up, so many of the things mentioned here. Very timely messge, is anyone getting any help for this issue? maybe I could recomend it to my doc.

October 4, 2010 at 5:09 pm
(15) Paula says:

I love all your comments because it explains what I, and the rest of you, go through. Most people can’t begin to understand how we feel even when we try to explain it to them. I feel that this time of year I always feel worse than usual. Weather changes definitely relate to FM symptoms. Thanks for articulating this so well

October 5, 2010 at 3:07 am
(16) melinda says:

When ever I read things that are written from people that understand how it feels to have fibromyalgia, it makes me want to cry. It is enough to be miserable and in pain but to add on having no one believe you or understand is enough to make me want to just scream at the people who do not get it. Everything that has been described is as if my mind was read even though I could not describe the feeling. It makes me feel better to know I am not alone or crazy.

October 20, 2011 at 7:54 pm
(17) Susan W says:

These descriptions are very good but for me i feel as if every bit of energy has gone from every cell in my body so that i just feel limp & lifeless. I even wonder how there is enough energy for my heart to beat, it scares me to feel like this! Of course the pain is then overwhelming. Thank u for ur website, at least we know that we all understand what we’re going through! X

March 22, 2012 at 4:04 pm
(18) randy says:

I have experienced a really weird side effect. Whenver I have a really bad flareup, I totally quit biting my finger nails. I know this sounds bizarre, but I ahve bitten my nails constantly for 40+ years. Now when I get really bad, the “thought” of biting my nails totally goes way.

May 18, 2012 at 8:44 pm
(19) Peggy says:

THIS is exactly hiw i feel everyday sometime all i want to.do is cry its so bad and nothing i take helps its so hard everyday to go to work so glad someone understand….

May 19, 2012 at 10:29 am
(20) Sophie says:

You have to quit suffering and start surviving as I have learned many years ago. I know that I have had fms since childhood and I am 73 years old.

June 18, 2012 at 12:58 am
(21) Katherine says:

Thanks explains exactly how I feel. Sounds werid but good to know that other people feel the same as some days I feel like I’m going crazy. The fatigue is overwhelming. I too feel like I’m being pulled down, and carrying a ton of bricks on my body, arms, legs everything feels so heavy. No motivation as just so tired, takes all my energy to do the washing and get mently ready for the kids to get home from school. Feel ready for bed now 5 pm even though wont do any good, but it feels like you would if you were normal at been up till 3 in the morning and run a marathon or two with the flu, and been hit with a sledge hamer all day every day. Thats the tirdness of fibo.

October 11, 2012 at 11:46 am
(22) Tammy McCray says:

That explains exactly how i feel every day. I wake up feeling like i want to crawl right back under my blankets and not get up. I am on Lyrica, meloxicam and numerous vitamins. I even had a vitamin b12 shot, which only worked for like 2 wks. The scariest thing about fybro fatigue is fighting the urge to sleep when u have a sick kid at home, and it happened to me 2 wks ago. I am very very happy to be pain free (well for the most part), but this falling asleep at the drop of dime is not cool. I just wish there was something that we could take to boost these lvls of depleted energy.

March 9, 2013 at 3:14 pm
(23) Nameismoon says:

Please comment if anyone has problems taking roadtrips in a car due to fibromyalgia. About 1 1/2 hour into a roadtrip, I begin feeling tired and aching all over my body. It becomes unbearable to travel any farther because of the “bumps” in the road aggravating my condition. I know it is not “all in my head”. Please comment.

March 19, 2013 at 9:00 pm
(24) JUDY s says:

some people are rude and think you are just a complainer and have what ever every one else has. If I tell them I suffer from cronic fatigue due to all the radiation treatments I had they believe me. I tell people I suffer from fibromyalgia and all of a suddon Im a hypocondreack. I know this is misspelled. my doctor told me when I go to see another doctor about a problems that he refers me to, that I shouldn’t tell them I have fibromyalgia because they may just here that and say its another sympton to firomyalgia and let it go as that.So many of us may be haveing a magor problem going on and have it missed from just saying I have fibromyalgia. I just had to back surgeries done and it was only until I took his advice that they started to do MRI and other test. before it was fibromyalgia is a serious condition and affects all your body and now I still have my fibromyalgia but my back feels so much better. What can I say if I was to play a tape of my complaining I’m sure I would sound like a hypocondreack. We know what we feel like and as long as we know how bad we are then I think it is ok for all of us to grype about our pain and let them know the next time they are very sick with flu or what ever else that we feel this way every day and we don’t get over what we have.

April 1, 2013 at 4:09 pm
(25) Nameismoon says:

Thanks Judy. Now I know not to mention Fibromyalgia and maybe the doctor will take my pain more seriously.

June 26, 2013 at 10:54 am
(26) Helen says:

My case is my emotional ups and downs make everything worse; have a number of ailments and drs. kind of think I am “nuts”. Most tests show I have physical problems but they don’t want to treat them; was told by primary I need to go to a shrink; refused to give me anxiety medication, said “he didn’t believe in it”. Thought a dr. was supposed to put the patient’s welfare first, not judge by his own feelings. Looking for a real doc.

July 11, 2013 at 9:37 am
(27) michelle says:

I am so tired and my eyes want to close, its not like normal tiredness, feels like every bit of enery has been sucked out of me and everything wants to close down, my vision is fuzzy
what can it be?
I get it regular at least once a day

July 18, 2013 at 1:58 am
(28) Esther says:

Amazing …this fatigue. I have suffered low thyroid. BUT this ?, when it passes through, unwanted and unexpected, is like a recovery mode from a major illness fatigue. SOME people just dont understand. Nor care…Such is life. Carry on and know it will pass.

July 23, 2013 at 4:52 pm
(29) Bill says:

My problems started about 7 years ago when I was 59. Men aren’t supposed to show weakness but I am having trouble keeping my ‘mask’ on. Peripheral Neuropathy at first, then widespread aches and pains. Now, for the last 18 months, constant tiredness. My GP has now suggested I may have Fibromyalgia but it has taken a while for the diagnosis to be made. Taking Tramadol for the pain and now started on Lyrica. Just want my life back. Any helpful suggestions to help with the tiredness? Good luck to all of you who are suffering.

August 16, 2013 at 8:16 am
(30) george says:

If you feel so fatigued you should have your cortisol levels checked. Too much cortisol will cause many of the symptoms that you all seem to have. Stress causes cortisol levels to go up and then your body’s immune system weakens. When the immune systems weakens your body cannot properly heal itself. I would advise you all to have your cortisol level checked via a blood test from your doctor.

February 19, 2014 at 12:31 am
(31) loggiehelenloggire says:

When the fatigue hits me it is instant and last 2-3days nothing you can do about it just have to go along with it

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