Exams and Tests to Diagnose Fibromyalgia

Even though the tender point exam is out, physicians will take a thorough medical history, including a questionnaire of where it hurts.

Unfortunately, there isn't one exam or test your doctor can use to diagnose fibromyalgia. The diagnosis of FM is made both by the art and science of medicine. The basic signs and symptoms of FM include persistent (≥ 3 months) widespread pain (tenderness/pain on both sides of the body, above and below the waist), along with stiffness, fatigue, non-refreshing sleep, cognitive difficulties.

One reason fibromyalgia is so hard to diagnose is that there are several other conditions, including rheumatoid arthritis and lupus, that have similar symptoms, so diagnosing fibromyalgia can become a process of elimination.

Another reason that makes fibromyalgia a challenge to diagnose is that it's a variable disorder, which means that symptoms can be different from person to person.

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Although these factors make it difficult to diagnose fibromyalgia, there are some general guidelines many doctors follow.

General Guidelines for Diagnosing Fibromyalgia

In 1990, the American College of Rheumatology (ACR) developed general guidelines for diagnosing fibromyalgia. According to their research, there are 2 main symptoms that must be present to diagnose fibromyalgia: widespread pain and tenderness at 11 or more of the 18 tender points.1

In 2010, the ACR revised their criteria, eliminating the tender point examination and replacing it with two scales: The Widespread Pain Index and the Symptom Severity Scale. Both are given to the patient at the time of her appointment and measure the extent of pain, fatigue, cognitive symptoms, etc., during the past week.2

Fibromyalgia Diagnostic Process
To help your doctor make an accurate diagnosis, he or she will do a complete medical history, asking you whether you have any conditions or if you have a family history of any conditions.

Your doctor will also ask you to describe your symptoms, so be as specific as possible. You may even want to keep a pain diary to record when and where you experience pain as well as the intensity of it. You can share this pain diary with your doctor during your appointment.

For example, record whether you've been having trouble sleeping or if you feel exhausted all the time. These are key symptoms that can help your doctor with a fibromyalgia diagnosis.

Although no longer part of the ACR guidelines, your doctor may still perform a physical examination.3,4

However, if you're not diagnosed with fibromyalgia at this appointment, try to stay patient—your doctor is working hard to find the exact cause of your symptoms.

Other Possible Tests for Fibromyalgia
Before making an official fibromyalgia diagnosis, your doctor will want to rule out other conditions, such as rheumatoid arthritis and lupus, that have similar symptoms.

To eliminate other possible conditions, your doctor may order multiple tests, including:

  • antinuclear antibody test
  • complete blood count
  • calcium/phosphatase levels
  • creatine phosphokinase
  • erythrocyte sedimentation rate/C-reactive protein (CRP) tests
  • genetic markers
  • liver and kidney function tests
  • rheumatoid factor test
  • thyroid tests
  • Vitamin D

Remember, the fibromyalgia diagnostic may be time consuming, and it's crucial for you to stay informed throughout the process. Ask questions if you don't understand test results, for example.

Ultimately, monitoring your symptoms and ruling out other conditions can help your doctor make an accurate fibromyalgia diagnosis.

Updated on: 04/12/16
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