Fibromyalgia Diagnosis

Fibromyalgia Diagnosis

Some people experience various levels of pain for years before seeking medical help. And even then, they often spend further years going from doctor to doctor, hearing different theories about the source of their pain before a diagnosis of fibromyalgia is established.

The reason for this long process lies partly in the fact that the pain is often slow to develop, so sufferers delay seeing a doctor in the hopes that it will just get better. Another reason is that so many conditions need to be ruled out – so many specialists visited – before a diagnosis of fibro can be given. There is no specific lab test that can definitively diagnose fibromyalgia.

Finally, some doctors even to this day believe that fibromyalgia is not a real medical condition and that the source of the pain has a different explanation.

Fibromyalgia Diagnosis Basics

So how does the diagnosis process work? If a doctor suspects fibromyalgia, he or she might start with an 18-point tender point exam. This was more prominent in the past and new guidelines no longer require it, but it is a quick test so it is still commonly done. Basically, all it involves is the doctor firmly pressing down on 18 parts of your body while you report which points felt painful. If 11 or more were painfully tender, that is considered widespread enough to warrant additional testing. But this is somewhat arbitrary and a person may still have fibro with fewer pain points.

The main aspect of the pain that is relevant is for how long the patient has experienced it. If the pain has been a problem for three months or more, that is considered chronic and fibro is more likely.

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Ruling Out Other Conditions

The next step is to rule out other conditions that could be causing the symptoms. The most common conditions that fall under this category are chronic fatigue syndrome, rheumatoid arthritis, and multiple sclerosis. But even if it is determined that you have one of these other conditions, you could still have fibromyalgia as well.

Blood tests can rule out some of these other conditions. This specific blood testing is done to check complete blood count, erythrocyte sedimentation rate, cyclic citrullinated peptides, rheumatoid factor, and thyroid function among other things. X-rays and other scans might be ordered as well.

It is often a specialist such as a rheumatologist rather than your general practitioner that makes the final diagnosis, assuming all other conditions are ultimately ruled out.

The official criteria, according to NHS, is that you have to have:

  • Severe pain in three to six different areas of your body or milder pain in seven or more areas.
  • Symptoms that have stayed at a similar level for at least three months; and
  • No other reason for your symptoms has been found.

So that’s a brief overview of how fibromyalgia is diagnosed. Unfortunately, it’s not as clear-cut as some other medical conditions, which leads even medical professionals sometimes to question its legitimacy. But hopefully better methods of diagnosis will be discovered in the future.

References:
https://www.nhs.uk/conditions/fibromyalgia/diagnosis/
https://www.webmd.boots.com/pain-management/guide/fibromyalgia-tender-points
https://www.mayoclinic.org/diseases-conditions/fibromyalgia/diagnosis-treatment/drc-20354785

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