How to Rule Out a Fibromyalgia Diagnosis

Fibromyalgia or FMS, fibromyalgia syndrome, has received a lot of recent attention in the medical and pharmaceutical communities. Yet, even with this new attention, the condition is still greatly misunderstood and, therefore, difficult to diagnose. One reason fibromyalgia is difficult to diagnose is because it mimics many other diseases and conditions such as rheumatoid arthritis, lupus, multiple sclerosis and Lyme disease. The main symptoms of fibromyalgia are fatigue and widespread pain throughout the body in muscles, tendons and joints. Some patients also report sensations of numbness, tingling or burning in areas of pain. There are also many co-existing conditions with fibromylgia, such as depression, anxiety, irritable bowel syndrome and migraine headaches.

Instructions

Ruling out Fibromyalgia

• 1

  Consider other possibilities before offering a diagnosis of FMS. Currently, there are no blood tests, X-rays or other diagnostic screening to confirm a diagnosis. This means that FMS is a diagnosis of exclusion. All other possibilities must be ruled out before the FMS diagnosis is made.

• 2

  Pay close attention to the patient's symptoms. FMS symptoms vary greatly between patients, though most will report widespread pain and fatigue. A thorough patient history must be taken to determine the duration and type of symptoms to see which diseases and conditions can be ruled out immediately and for which diseases and conditions further testing is needed. There are many specific screenings that can be done to rule in or out some, though not all, diseases that mimic FMS, such as rheumatoid arthritis or multiple sclerosis.

• 3

  Do a tender-point exam. Though FMS symptoms can vary from patient to patient, one hallmark of FMS is the presence of pain and tenderness in at least 11 out of 18 specific tender points on the body. These points are located in the areas of the neck, chest, buttocks, knees and elbows. Adequate training is necessary to locate these points, as well as to apply the correct amount of pressure to determine the degree of pain and tenderness. Only a qualified practitioner should perform this exam.

• 4

  Use the results of laboratory tests, scans and the tender-point exam, along with the patient's history to determine if the patient truly has FMS. Once all other possibilities are ruled out, only then should an FMS diagnosis be considered. If there is still uncertainty that FMS or another hard-to-diagnosis condition is present, such as lupus or Lyme disease, it may be necessary to wait for additional symptoms to appear before all other possibilities can be ruled out and FMS can be confirmed.