There is no particular laboratory or imaging testing for fibromyalgia diagnosis. As a result, the diagnosis is often dependent on comprehensive patient history, a thorough physical examination, and a limited number of blood tests designed to exclude illnesses with comparable symptoms.
Individual diagnostic protocols have been employed, and different health care professionals’ processes may differ, but all procedures entail analyzing your pain, exhaustion, and other potentially linked symptoms.
In 1990, the American College of Rheumatology (ACR) created categorization criteria for fibromyalgia, which are frequently utilized to aid in diagnosis. A person is diagnosed with fibromyalgia if he or she has widespread musculoskeletal discomfort and excessive sensitivity in at least 11 of 18 distinct “sensitive spots” (based on clinician examination).
In 2010, the ACR published new diagnostic criteria. These criteria do not necessitate a tender point examination, instead, use a numerical score system based on how broad and intense a person’s pain is described. They also assess additional symptoms such as weariness, cognitive challenges (such as difficulty thinking effectively), and pain-related disorders such as headaches or stomach troubles.
Among the diagnostic criteria proposed by the Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTION)-American Pain Society (APS) Pain Taxonomy are multisite pain (defined as at least six out of nine possible sites) and moderate to severe sleep problems or fatigue that have been present for at least three months (AAAPT).
If you have fibromyalgia symptoms, your doctor should take a medical history and perform a physical exam to rule out arthritis, other connective tissue issues, neurologic illnesses, and other disorders. Routine laboratory testing may be performed to help rule out illnesses such as inflammatory arthritis, thyroid disease, and muscular issues. The results of these tests are normal in the majority of fibromyalgia patients.
Because fibromyalgia patients typically experience symptoms other than muscular pain, such as chronic tiredness, headache, extra pain sensations, and sleep and mood disorders, your doctor may additionally recommend the following:
If you have symptoms of depression or anxiety, you may be referred to a mental health expert for additional examination or therapy.
A detailed sleep history – If your sleep history shows a sleep disorder such as restless legs syndrome or sleep apnea, you will be sent to a sleep expert for further examination and treatment.
Conditions that are related to fibromyalgia
In certain circumstances, evaluating whether a person’s signs and symptoms are due to fibromyalgia or another ailment can be a lengthy and difficult procedure. Many conditions can produce widespread muscular pains, exhaustion, and other fibromyalgia symptoms.
Fibromyalgia can develop in persons who have rheumatoid arthritis, systemic lupus erythematosus, osteoarthritis, and other disorders (see below). If this is the case, determining whether your symptoms of persistent pain and exhaustion are caused by fibromyalgia or another ailment may be challenging. This frequently necessitates consulting with a rheumatologist.
A sample of illnesses that your doctor may explore throughout the diagnosis procedure is as follows:
Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) – RA is a chronic condition that causes joint inflammation, resulting in pain, edema, and probable joint deformity. SLE is also a chronic, inflammatory connective tissue illness that can affect several organs.
Although RA and SLE have many symptoms with fibromyalgia, they also have traits that fibromyalgia patients do not experience, such as inflammation of the synovial membranes (the connective tissue that lines the spaces between bones and joints).
Osteoarthritis (OA) – OA is a condition that causes stiffness, soreness, discomfort, and probable joint deformities in elderly people. Doctors can tell the difference between OA and fibromyalgia based on a patient’s medical history, physical examination, and x-ray data (in OA, x-rays can show degenerative joint changes that are not present in fibromyalgia).
Ankylosing spondylitis (AS) – AS is a chronic, progressive inflammatory disease that affects the spine’s joints. This disorder causes spine stiffness, discomfort, and limited mobility. AS also generates distinctive x-ray results that are missing in persons with fibromyalgia. Spinal motion and x-rays, on the other hand, are frequently normal in persons with fibromyalgia. Polymyalgia rheumatic (PMR) – PMR is a chronic, inflammatory disorder that produces stiffness and discomfort in the shoulders, hips, and other joints. The condition, which typically affects persons over the age of 50, is commonly linked to inflammation of particular major arteries. A person’s medical history, physical examination, and blood tests are used to distinguish PMR from fibromyalgia.