Understanding the Diagnosis Process of Fibromyalgia


Understanding the Diagnosis Process of Fibromyalgia

Reaching a Fibromyalgia Diagnosis

If you have been experiencing chronic pain and fatigue, among other odd symptoms, you may wonder if you have the condition fibromyalgia.

Some of the most common symptoms of fibromyalgia may include:

  • Widespread pain
  • Fatigue
  • Mental fogginess
  • Stiff joints or muscles
  • Irritable bowel syndrome
  • Headaches
  • Jaw pain
  • Anxiety or depression

If this sounds like you, you will likely be wanting to know what the diagnosis process is for fibromyalgia.

Unfortunately, right now no single test can be done to diagnose fibromyalgia definitively. More research is currently being done to develop a blood test to confirm that a person has fibromyalgia. It is hoped that this test will be ready for use in five years to help those suffering from the symptoms reach a proper fibromyalgia diagnosis. In the meantime, doctors have to use other means to diagnose this painful illness.

How Is Fibromyalgia Diagnosed?

The first step is to see your doctor, either your general practitioner (GP) or preferably a rheumatologist. The American College of Rheumatology (ACR) has set guidelines that a doctor will look for before diagnosing a person with fibromyalgia.

Your doctor will look for specific symptoms, such as:

  • Widespread pain that has lasted for at least three months. Widespread pain is defined as pain that occurs on both sides of your body, in addition to above and below your waist.
  • Presence of other fibromyalgia symptoms, such as fatigue, waking up tired, trouble with memory and difficulty thinking clearly.
  • No other conditions that could cause the symptoms.

In addition to a physical exam of your muscles and joints, your doctor will likely want to do a number of blood tests. Some of the tests they may do include:

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  • A complete blood count.
  • A test of your erythrocyte sedimentation rate (ESR). A sed rate test can detect the presence of inflammation in your body, as well as monitor inflammation levels.
  • A test of your thyroid function.
  • Your vitamin D levels.

As mentioned above, it is important that your doctor rule out any other possible conditions that have similar symptoms, such as:

  • Rheumatic diseases. Conditions such as rheumatoid arthritis, Sjogren’s syndrome, lupus, and ankylosing spondylitis have some of the same symptoms.
  • Mental health problems. Disorders such as depression and anxiety often cause generalized aches and pain and can cause fatigue.
  • Neurological disorders. Some with fibromyalgia experience numbness and tingling, symptoms that mimic those of disorders such as multiple sclerosis and myasthenia gravis.

The Diagnostic Criteria for Fibromyalgia That Is No Longer Used

In the past, the ACR included the tender point test as part of the criteria to diagnose a person with fibromyalgia, but this is no longer considered accurate enough to be used as a diagnostic test.

For this test, the doctor applies pressure to 18 spots on the body. This includes the back of the head and neck, and spots on the shoulders, elbows, knees, and hips. If 11 or more of these spots were tender, the doctor would give a fibromyalgia diagnosis. However, it is now known that fibromyalgia pain and tenderness can come and go and vary in intensity.

Some doctors may still use this test to monitor their patient’s pain levels.

Sadly, from personal experience, I can tell you that this is not a fun test to have done. When I first was diagnosed, over nine years ago, this test was done every time I visited my rheumatologist. I frequently said that if I was not hurting before I went to the doctor, I was afterward.

Is Fibromyalgia a Real Diagnosis?

There are some that still believe that a fibromyalgia diagnosis is doctor code for “I don’t really know what is wrong with you.” However, this is simply not the case because fibromyalgia is a real illness!

According to Harvard Health Publishing, “experts believe [fibromyalgia] may be caused by a malfunctioning nervous system. Researchers using magnetic resonance imaging to examine the brains of people with fibromyalgia have found abnormalities in the part of the brain that processes pain signals from the body. It appears that this part of the brain is essentially boosting the intensity of normal pain signals, potentially causing the body to feel pain without a physical cause.”

Why though is there still such a stigma surrounding fibromyalgia? Part of the problem likely stems from the fact that people with fibromyalgia look healthy even though they do not feel healthy. It seems that this can be a difficult concept for some to wrap their mind around.

However, as time goes on and more is discovered about this illness, the more society as a whole will accept it.

Learning to Cope With a Fibromyalgia Diagnosis

There is no one treatment for fibromyalgia. However, there are a number of things that can help us cope with some of the most troublesome symptoms that we live with.

  • Medication. There are a number of prescription and over the counter medications that can help to lessen pain levels.
  • Supplements. Vitamins and supplements can help with a variety of symptoms, such as pain, fatigue, muscle cramping, and can help to promote better sleep.
  • Exercise. Gentle, low impact exercise has been found to be one of the best ways to lessen overall pain. Finding balance in your activity levels can help to reduce fibro symptoms. Learning not to push yourself too hard, while also not doing too little, can really go a long way.
  • Support Groups. Having a good support system is an important part of coping with fibro. Having people in your life that will offer practical help is great, but having someone that will listen and offer moral support is invaluable. Not everyone has people in their life that are able to give that kind of support. This is where support groups come into play. Whether you meet with a local group or chat with people online, having others that have gone through what you are can be a great tool to help you cope.

Much is still not understood about fibromyalgia, but doctors and researchers are learning more all of the time!

Resources

Mayo Clinic (Fibromyalgia: Understand the diagnosis process)

Medical News Today (Groundbreaking blood test detects fibromyalgia)

National Fibromyalgia Association (Diagnosis)

Harvard Health Publishing (Is Fibromyalgia Real?)

News-Medical.net (Fibromyalgia: an interview with Dr. Frederick Wolfe, University of Kansas School of Medicine)

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by Starla Rich and Adriel Maldonado on November 2, 2017
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