Fibromyalgia Diagnosis
Diagnostic Tests

Fibromyalgia Diagnosis

Contents

• How Is Fibromyalgia Diagnosed?
• Physical Exam
• Tender Points
• Laboratory Tests
• Scans & Ultrasound

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For an overview, see:
Fibromyalgia Guide

How Is Fibromyalgia Diagnosed?

As there is no specific medical or biochemical defect associated with fibromyalgia, it can only be diagnosed after other potential causes have been ruled out. This is called a differential diagnosis, when all other factors based on symptoms; age and gender are ruled out. As so many doctors are inadequately informed about the condition, it is estimated that the average diagnosis takes about five years. This is not helped by the controversy within the medical community as to whether or not fibromyalgia is even a distinct condition. As fibromyalgia symptoms overlap with so many other conditions, the test process can be frustrating and long. Conditions for which a doctor may test for exclusion include:

• Certain types of arthritis, including rheumatoid arthritis
• Lupus
• Polymyositis
• Lyme disease
• Osteoarthritis
• Chronic fatigue syndrome (CFS)
• Myofascial pain syndromes (MPS)

As diagnosis can be difficult, the American College of Rheumatology, has issued the following guidelines for doctors:

1. There should be widespread musculoskeletal pain for at least 3 months on both sides of the body.
2. Pain experienced above and below the waist (for example, lower back and neck).
3. Pain experienced when at least 11 of 18 specified tender points are touched with a force of about 9 pounds or less.
4. Other symptoms occur such as sleep disorders and muscle stiffness.

Useful Article: Fibromyalgia Diet Plan
Fibromyalgia Diet, food to avoid/eat and herbal remedies.

Physical Examination

A physical examination and a complete medical history is the first and most important step towards a diagnosis. If your doctor is familiar enough with fibromyalgia, you should expect them to ask a variation of the following questions:

1. Is pain chronic and do you experience it constantly?
2. Does the intensity of the pain change, sometimes becoming worse?
3. Do you experience stiffness in the morning?
4. Do you have problems sleeping more than 3 times a week?
5. Are you feeling extremely tired, much more than other people you know?

Tender Points

Another important part of the diagnosis is whether or not you have tender points. Fibromyalgia tender points are different to trigger points (which feel lumpy, like a knot to touch). When a tender point is touched by a doctor, it does not feel any different to a healthy person (except for the person’s reaction to the pain!). According to the American College of Rheumatology, you must feel pain in 11 of the 18 chartered tender points. Some tender points may be very sore one day, and less painful the next. This can cause diagnostic problems as on the day of a doctor's appointment only 8 or 9 points may be sore, but the following week all 18 could flare up.

Laboratory Tests

Part of the doctor's examination may include a round of blood and urine tests. This will help to rule out autoimmune disorders such as arthritis or lupus. Thyroid levels may also be checked as an underactive thyroid can cause fatigue and muscle pain. Blood tests can also check for vitamin deficiencies, in particular for deficiencies in vitamin B12 and vitamin D. Also minerals such as potassium, calcium and magnesium can be tested. Vitamin and mineral deficiencies may cause weakness and pain. A blood test can also be used to screen for hepatitis B or C, AIDS or lyme disease.

Scans and Ultrasound

Occasionally a doctor may order a CT (computerized tomography) scan or MRI (magnetic resonance imaging) test to rule out a number of other causes:

Bone Diseases: A scan can check for any damage or abnormalities in the skeletal system caused by arthritis or other bone disorders.
Organ Problems: If an organ is malfunctioning (anything from a thyroid gland to the intestines), a scan will help identify the issue.
Brain Abnormalities: Such as aneurysm.

An ultrasound scan is less stressful than a CT or MRI scan, and may be used to identify organ abnormalities and nerve tissue problems. In particular it can reveal if there is tissue damage or inflammation which would indicate another problem rather than fibromyalgia (or in addition to it!).

Related Questions And Answers
• What are the symptoms of fibromyalgia? Top 10 signs. Take our quiz to see if you are a possible candidate!
• What type of doctor treats fibromyalgia? From family physician to specialist medical care.
• Is fibromyalgia genetic? Can you inherit the condition?
• Can fibromyalgia be cured? What a doctor should tell you.
• What is the difference between chronic fatigue syndrome and fibromyalgia? How to tell the difference between one similar illness and the other.

Related Articles on Fibromyalgia

For more on gynecological pain, see the following:

• Fibromyalgia Causes: Learn what the scientists think, possible theories range from genes to a trauma and viral infection.
• Fibromyalgia Treatment: Therapies, over the counter and prescription medications.
• Fibromyalgia Exercises - For Pain Relief. See which are the best types of exercise for this condition.
• Fibromyalgia Medications - over the counter and prescription.

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