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Diagnosis of Fibromyalgia

Fibromyalgia is a chronic condition that is difficult to diagnose. Widespread pain and fatigue characterize fibromyalgia, but these symptoms are not unique to the condition. No specific tests confirm or rule out fibromyalgia. Rather, the condition is diagnosed by eliminating all other potential causes of the pain. Diagnosis typically takes years consulting with doctors in various disciplines, such as rheumatology, neurology and orthopedics.

  1. Fibromyalgia Symptoms

    • Fibromyalgia symptoms are nonspecific and vary from person to person. Although fibromyalgia is chronic and the pain can last for months or years, not all symptoms are always present. All over musculoskeletal pain is the most common symptom, but the pain does not worsen with time and it is not accompanied by inflammation. Other symptoms may include fatigue, sleep disorders, irritable bowel syndrome, chronic headache or jaw pain, impaired memory, numbness or tingling in arms or legs, dizziness or lightheadedness and muscle stiffness in the mornings.

    Diagnosis

    • Diagnosis can be a lengthy process. Laboratory tests, X-rays, CT scans or MRIs are normal and cannot confirm fibromyalgia. A thorough physical examination rules out conditions, such as anemia, rheumatoid arthritis, hormonal imbalances, infection, hypothyroidism, cancer or diseases of the muscles, joints, bones or nerves. Fibromyalgia is often misdiagnosed as Lyme disease or arthritis.

    Tender Points

    • The American College of Rheumatology (ACR) developed criteria to diagnose fibromyalgia. Patients must have widespread pain for at least three months and the pain must be present in all four body quadrants (right and left sides and above and below the waist). Patients must also have pain in 11 of 18 tender points, which are specific areas that, when pressed gently, cause pain. Fibromyalgia may be diagnosed if a patient has fewer than 11 tender points if the patient also has widespread pain plus other symptoms of fibromyalgia.

    Limitations

    • Not all patients with fibromyalgia have all symptoms and pain may vary from day to day. Some patients have pain in areas other than the tender points, and patients may have pain in fewer than 11 tender points on any particular day. Similarly, some patients may not have pain in all four quadrants.

    Alternative Tests

    • Analyses besides standard laboratory and imaging tests may be more specific in diagnosing fibromyalgia, but their validity is unconfirmed. Hair analysis detects high levels of calcium, magnesium, and toxins, such as aspartame, that have been associated with fibromyalgia. People with fibromyalgia feel pain when only mild pressure is applied to their skin, such as during a routine blood pressure test. Assessing the amount of discomfort a person feels during a blood pressure test may help confirm the diganosis of fibromyalgia. Fibromyalgia affects a patient's ability to exercise. Peak flow oxygen levels, which is the volume of oxygen used when an individual exercises, can indicate a patient's progress on treatment.

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