How is fibromyalgia diagnosed?
Posted: Jan 20, 2021
Fibromyalgia is a chronic pain condition that is often difficult to diagnose as the symptoms often mimic those of many other conditions. The true cause of the symptoms is important so that proper treatment can be provided. The general symptoms of fibromyalgia include widespread body pain, fatigue and poor sleep. However, all of these symptoms are common to many other conditions. To complicate it further the fibromyalgia symptoms can occur alone or along with other conditions, so it can take some time to work out which symptom is caused by what problem. To make things even more confusing is that the symptoms of fibromyalgia often come and go over time.
Fibromyalgia is probably due to changes in how the brain and spinal cord process pain signals which generally means that the diagnosis is usually made based on a group of symptoms. The diagnostic guidelines put out by the American College of Rheumatology include widespread pain throughout the body for at least three months. It is also often characterized by pain when firm pressure is applied to specific areas of your body, called tender or trigger points. Previously to make a diagnosis at least 11 of these 18 specific spots had to test positive for tenderness, but this is not a strict criterion anymore as they can vary so much.
An important part of the diagnostic process is to exclude other possible causes of the symptoms. Some of the common causes of the types of symptoms include some of the rheumatic diseases such as rheumatoid arthritis, Sjogren's syndrome and lupus. Mental health disorders such as depression and anxiety often feature generalized aches and pain. Sometimes the numbness and tingling that those with fibromyalgia might get can be caused by neurological disorders such as multiple sclerosis and myasthenia gravis.
There are no lab or blood tests that are diagnostic, but they are widely used to help either diagnose other causes or rule them out. The tests may include a complete blood count, erythrocyte sedimentation rate, cyclic citrullinated peptide test, rheumatoid factor, thyroid function tests, anti-nuclear antibody, celiac serology and Vitamin D. Doctors will also perform a careful physical exam of the muscles and joints as well as a neurological examination. A sleep study is sometimes recommended.
An important issue in fibromyalgia is sleep quality. People who have it can often wake up tired, even after they have slept continuously for more than eight hours. They tend to fatigue and get tired easily. Fibromyalgia can often coexist with other health problems which can include irritable bowel syndrome, headaches, anxiety or depression, frequent or painful urination. There can be a number of triggers of fibromyalgia as in some cases it begins shortly after a person has experienced a mentally or physically traumatic event, for example a car accident. Post-traumatic stress disorder appears to be a factor in some cases. Genetic factors also appear to be involved, so a family history is important.
All of this information taken together and patterns in it are looked for to give your doctor a much better idea of what may be causing your symptoms and if it is fibromyalgia.
Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.