Fibromyalgia Diagnosis

Many of the signs and symptoms of fibromyalgia are similar to other disorders, thus diagnosing fibromyalgia may take a considerable amount of time. Most patients find themselves going through various tests and consulting several doctors before receiving their diagnosis. Primary care physicians may refer their patients to rheumatologist for evaluation and management.

There are no definitive laboratory tests or imaging procedures for fibromyalgia. It is diagnosed based on reported symptoms and physical examination. Fibromyalgia may be suspected in any person who experience muscle and joint pain with no identifiable cause.

Diagnosing fibromyalgia begins with health history taking. The health history consists of a series of questions that will give an overview of the present health situation. The patient's lifestyle, activities of daily living, interpersonal and physical environment, and previous health problems are explored thoroughly. The doctor will also ask about the patient's current symptoms; when do they usually occur, and what seems to trigger them or make them worse.

After the interview, physical examination will be carried out. The doctor will check the tender points, these are 18 specific sites on the body that are markedly sensitive touch in fibromyalgia patients. The tender points that are used for diagnosis are found around the neck, chest, shoulder, hip, knee and elbow regions. To assess the tender points, the doctor will apply light pressure on the surface of the muscles, people with fibromyalgia will find this painful.

Below is diagnostic criteria established by the American College of Rheumatology for fibromyalgia:

• History of widespread pain lasting at least three months

• Pain on at least 11 positive tender points upon palpation

Blood test and other diagnostic procedures

There are no markers in the blood or changes in the x-ray that can confirm a diagnosis of fibromyalgia. However, the doctor may still request for some tests to rule out other disorders that have similar symptoms. Blood tests may include:

• Complete blood count

• Erythrocyte sedimentation rate – used for diagnosing conditions associated with inflammation, infections, some cancers, and autoimmune diseases.

• Thyroid function tests – Thyroid function may be assessed because some clinical features of fibromyalgia resemble those of hypothyroidism.

X-ray

Helps rule out diseases that affect the joints,bones and muscles. The doctor may also consider these tests to examine nerve and muscle function.

Electromyography (EMG). This test helps in examining the condition of the muscles and the nerves that control them. Electromyogram records the muscle's electrical activity. During this test, the doctor will insert needle electrodes into the muscle tissue. The electrode on the needle detects the electrical activity given off by the muscles. Electromyography helps distinguish the conditions that are caused by the muscles themselves, and weaknesses that are caused by certain nerve disorders

Nerve conduction velocity (NCV)

A nerve conduction velocity test used to determines the speed of electrical signals through a nerve. Electrodes are placed the skin to stimulate the nerve an electrical impulse. The patient will feel a sensation similar to an electric shock. This test helps detect presence of damaged nerves.

Wallace, D., Wallace, J. Making Sense of Fibromyalgia. 2009.

Oxford University Press.

Goldberg Group, Anderson, J., Trivieri,L. Alternative Medicine: The Definitive Guide.1997. Alternativemedicine.com books

Oelke, J. Natural Choices for Fibromyalgia: Discover Your Personal Method for Pain Relief. 2003. Natural Choices, Inc.