Diagnosing Fibromyalgia

Fibromyalgia is a chronic pain disorder whose cause is still unknown, and there is no one test that can diagnose this condition.

Furthermore, the symptoms of fibromyalgia are easily confused with other chronic issues like thyroid problems or Lyme disease, and as such it is commonly misdiagnosed at first.

In previous times, a fibromyalgia diagnosis could only be given if a patient presented at least 11 of 18 recognized tender points, and could only be officially diagnosed by a rheumatologist.

Now, because fibromyalgia is a condition with ebbs and flows and is more common that previously believed, new diagnostic criteria have been created for use by general practitioners.

Causes of Fibromyalgia

There is no consensus on what causes fibromyalgia. Many think it is linked to low levels of serotonin in the brain, others feel its root can be found in a traumatic event, like a car accident or surviving combat.

Preliminary research has shown that people with post-traumatic stress disorder are more likely to develop fibromyalgia, so a mental cause is as likely as a physical one.

There may also be a genetic component to fibromyalgia, so a doctor might ask if any other family members suffer from similar symptoms.

Fibromyalgia Symptoms

The symptoms of fibromyalgia are numerous and often coincide with other health problems, so making a diagnosis can be a long, painful process.

The condition has been linked to a change in the way the brain and spinal cord process pain, and finding the source of pain can be tricky at the best of times.

Usually, doctors can find the source of pain with blood tests, x-rays or physical exams, but fibromyalgia symptoms don’t show up on any of those tests.

Instead, fibromyalgia presents a confluence of symptoms, such as widespread pain, fatigue, difficulty focusing, headaches, insomnia, anxiety, depression, jaw pain, irritable bowel syndrome, inappropriate pain response and many more.

In order to receive a diagnosis of fibromyalgia, symptoms will need to have lasted for at least three months, and have no other underlying cause like anemia or thyroid malfunction.

Concurrent Disorders

If a doctor suspects a patient has fibromyalgia, they will ask a series of questions about any other health problems that patient may also experience.

These questions could range from inquiries about bladder and bowel habits, social activities, personal relationships, sleeping, eating, headaches, migraines or jaw pain, recent trauma, general state of mind, mood and energy level, in addition to questions about the patient’s pain.it is very common for individuals to suffer from other problems like irritable bowel syndrome, chronic fatigue, TMD and interstitial cystitis.

Diagnosing Fibromyalgia

Misdiagnosis

To avoid misdiagnosing fibromyalgia, doctors will perform several tests to rule out other conditions.  They will run a complete blood count, test vitamin D, B 12, iron levels and thyroid function, and test for Lyme disease.

Depending on your age and lifestyle, they may want to test blood sugar and cholesterol as well, since diagnosing fibromyalgia is more of a process of elimination than inclusion.

A doctor may refer a patient to several specialists, like a neurologist or gastroenterologist, to test for neurological or digestive disorders first.

Depression is also known to cause pain, so they may refer someone complaining of pain to a psychiatrist as well.

It may be a good idea to seek the advice of this type of professional for someone with fibromyalgia anyway, to rule out psychiatric illness and manage medications.

Diagnostic Criteria

The current guidelines for diagnosing fibromyalgia include a set of criteria rather than focusing on pain and its location in the body. The first is widespread pain.

This means that the patient describes pain located on both sides and the upper and lower halves of the body.

This pain may localize in several parts of the body, causing the neck, back, hips and knees to hurt at the same time.

The second is chronic fatigue, which refers to feeling extreme exhaustion all the time, regardless of activity level.

The third criterion for a fibromyalgia diagnosis is unrestful sleep, meaning the patient must not feel rested even after eight hours of sleep or more.

The fourth criterion is an abnormal pain response which can be described as tenderness. This is called allodynia, and can make normal activities like a hug or a pat on the back excruciating for someone with fibromyalgia.

The patient might also experience hyperalgesia, or more commonly a heightened pain response. The final aspect of a fibromyalgia diagnosis is concentration or short term memory problems, as people with this condition often report difficulty maintaining focus and forgetfulness.

If a doctor is still unsure, they may still refer to the American College of Rheumatology diagnostic guidelines and evaluate a patient’s tender points in addition to the new criteria.

Final Stage of Diagnosis

Once someone has endured the mandatory tests, evaluations and procedures, and a competent doctor has completed the necessary evaluations, after all the appointments and months of enduring pain on a daily basis, only then will a doctor give a diagnosis of fibromyalgia.

It may take seeing several different doctors before finding one that doesn’t simply give up or dismiss these kinds of complaints.

For someone in constant pain, it can become their mission to find out what’s going on, others may shut down entirely.

It takes persistence to get a final diagnosis of fibromyalgia because unfortunately, many in the medical community do not believe it exists.

While its cause may be unknown, fibromyalgia is very real to the millions of people suffering from it. It is a condition that can come and go depending on the season, lifestyle or stress level, and its affects can’t be seen from the outside.

People with fibromyalgia are often accused of faking it or looking too good to be sick, and those around them don’t understand their lethargy and reluctance to do things.

For many, finally getting a diagnosis can come as a huge relief, as they can finally put a name to their suffering and begin the healing process.

4 Comments

  • It is a long process and there are still Doctors who will actually roll their eyes in front of you and state that there is no such illness. I have also read that fibromyalgia does not get worse as you age…WRONG…I was able to deal with the pain when I was younger (I was diagnosed in 1992 by Mayo Clinic) I was 33 at the time and now, I am 57 soon to be 58 and I hurt so much more now. i HAD ONE HELL OF A CHILDHOOD and I have been in 4 car accidents. Is this why I hurt so much? I am now being seen by a pain management clinic which I am not crazy about. They are very limited as to the medications they can give out and I have been on so many that do not work and what I was on, this clinic can not prescribe! It is a vicious cycle.

  • It took years to be diagnosed. Worst part is, they ended up finding other conditions during this elimination process. In turn, found 16 medical conditions from an Enlarged Prostate (Begnin Prostatic Hyperplasis). I had chronic fatigue and high cholesterol diagnosed years before the pain gradually exceeded what I could take. Have Bursitis to Gastroesophageal Reflux (GERD). My depression started before my Fibromyalgia was even known to me as a medical condition, never heard of it before. Since then I developed Social Anxiety Disorder. My doctor called my Fibromyalgia by medical term Musculoskeletal Disorder. Each day is brought on by torturous pain that hard to get out of bed. Times when I would wake up in the early morning ours, saying crap (nicer way of saying then the actual words I said), still here for another painful and agonizing day. When I go to bed, always said to myself, please take me, don’t want to suffer anymore!!!

  • Where can I go to get me tested as I have all off these symptoms. I have constant pain and can hardly sleep and do my daily work.

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