This is take two of an article I wrote a few weeks back (when I had a brain!). It’s a companion piece to the one for college students with FMS—an introduction to FMS for educators.

I’d appreciate feedback from anyone who has the time to read it. I don’t expect most of you will be interested, though, as it’s pretty focused on one topic.

This is a very rare friends-locked post since I will be submitting the article for publication. Please do not share the article with anyone else.

Fibromyalgia: An Introduction for Educators

If you’ve been given this article, you probably have a student in your class who suffers from fibromyalgia. As this complex syndrome is often misunderstood, this article will attempt to give you the information you need and guide you to other resources if you’re interested in them.

Fibromyalgia Syndrome (FMS) is a debilitating neurological disorder characterized by chronic widespread pain and fatigue. It affects approximately 2% of the population and is more common in women than in men. Central nervous system sensitization affects the entire body, leading to many secondary symptoms. Those symptoms will vary from one person to the next, but often include migraines, irritable bowel/bladder syndrome, nausea, muscle spasms/cramps, numbness/tingling, and impaired coordination.

The severity of symptoms will vary from day to day, or even by the time of day. Stress and quality of sleep have a significant effect on the FMS patient.

FMS in the Classroom

In an academic setting, the main issues that arise with FMS are flares, cognitive deficits, environmental sensitivity, and an impaired immune system.

Flares are episodes during which the FMS patient experiences increased symptoms. Those symptoms are usually far more intense than normal, and the patient may become bedridden. A stressor of some sort, such as an illness or injury, triggers most flares. Other factors, like seasonal or hormonal changes, may also provoke flares.

FMS patients experience variable cognitive deficits that include memory loss, confusion, and slow processing. During a flare, especially, most patients experience a phenomenon called “brain fog.” The student may have difficulty concentrating or paying attention, be easily confused, lose things, and require more time to complete assignments or tests. Having a quiet environment away from the classroom in which to take tests may help matters.

Your student is especially sensitive to just about everything in her environment-changes in the weather, temperature variations, drafts, lighting, odors, etc. It is important that your classroom environment be as stable as possible, and that aggravating factors such as flickering lights be remedied. Instituting a fragrance-free, smoke-free building policy is wise. Be aware of loose cords and other hazards that may cause falls, as the FMS patient may be unsteady on his feet. Don’t open windows in the classroom unless you’ve asked the student about potential allergen problems.

Finally, most FMS patients have impaired immune systems. Remind your students that if they have any kind of virus or other contagions, they should not attend class. If they must attend, ask that they sit away from the other students as much as possible.


The accommodations a particular student needs will vary depending on the severity of her symptoms and the specific secondary symptoms she experiences. Suggested accommodations that will help most students with FMS are listed here.

* Advance planning. Give the student information about assignments and deadlines as early as possible. Because she may experience a flare at any time, being able to work ahead of the schedule whenever possible can help her avoid falling behind the class. Be open to working out a contingency plan in case the student does experience a major flare during the semester.
* Memory aids. Provide information in writing. Hand out copies of any overheads or other documents used during class. Publishing class material on a website or similar resource may help other students as well as the FMS sufferer.
* Reduce distractions and stress. Keep the door closed while class is in session. Ask that other students refrain from making extraneous noises, such as drumming their fingers on their desks. Avoid outbursts or other loud noises.
* Breaks. The student may need to get up, move around, and stretch from time to time. She may need more frequent bathroom breaks than other students.
* Seating. The student may need to put her feet up or otherwise adjust seating in order to tolerate it. Un-cushioned seating may be intolerable. Be flexible and understanding.
* Group projects. The student with FMS may have problems in peer groups due to the need for accommodations and the unreliability of her health. Meetings and activities outside the classroom may present particular difficulties. If requested, allow the student to work independently whenever possible.
* Stamina. The student will have reduced stamina, and should not be expected to participate in activities that last more than a couple of hours. College lab courses, in particular, may present endurance problems. Work out a flexible schedule that respects the student’s physical limits while covering the course material. Permit the student to sit rather than stand.
* Coordination. Because the student may have impaired coordination, physical activities may present particular problems. Carrying out lab experiments, for instance, can be dicey when one’s hands shake or unexpectedly refuse to grip objects. Have another student or an assistant work with the FMS sufferer when necessary.
* Writing alternatives. Essay tests and other situations requiring any significant amount of writing may be difficult. If requested, allow the student to type material rather than writing it out. The student may need to use a recorder during lectures and should be offered the services of a note-taker.


Because fibromyalgia is an invisible disability, it can be difficult to remember that the student is, in fact, impaired. The variable nature of FMS requires that its sufferers monitor themselves carefully. The student may need a cane one day, but not the next.

Listen to the student. She knows her body and abilities better than anyone else. Respect her opinions, ask questions when necessary, and be prepared to deal with questions from other students in a sensitive fashion when necessary.

Each patient’s original abilities are unique, so her degree of impairment may not be immediately evident. A student who is highly intelligent and dedicated, for instance, may not seem to have any cognitive deficits. If, however, she states that she needs accommodations, they should be granted.


The following sources will provide more specific information should you need it.
* The Fibromyalgia Network,, PO Box 31750, Tucson, AZ 85751, 800-853-2929
* The National Fibromyalgia Association,, 2200 N. Glassell St., Suite A, Orange, Ca 92865, 714-921-0150
* The Job Accommodation Network, “Accomodating People With Fibromyalgia,”

Copyright (c) 2005, Cynthia L. Armistead, All Rights Reserved.

Cyn is Rick's wife, Katie's Mom, and Esther & Oliver's Mémé. She's also a professional geek, avid reader, fledgling coder, enthusiastic gamer (TTRPGs), occasional singer, and devoted stitcher.
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