How Is It Diagnosed?
According to the American College of Rheumatology, only 2-4% of people are diagnosed with fibromyalgia, so you may wonder, how does such an uncommon disorder get diagnosed? The answer? Not easily. Fibromyalgia shares many symptoms in common with other chronic pain disorders and diseases, such as chronic fatigue syndrome, hypothyroidism, rheumatoid arthritis, lupus, among others. Therefore, it can be misdiagnosed without thorough testing and investigation. Many of the similar conditions can be tested for in the blood, whereas fibromyalgia cannot, so one of the first steps might be to rule out other causes for your pain with blood tests such as a complete blood count (CBC) panel or a thyroid function test.
To specifically “test” for fibromyalgia, a doctor would see if your pain is widespread (in all 4 quadrants of your body), what kind of pain you feel, whether you experience significant fatigue, and whether you’ve had cognitive difficulties. He or she should also perform a physical examination, taking the time to press firmly on the various 18 tender points set forth by the American College of Rheumatology, pictured above. It is generally said that if 11 or more of the points are indeed tender, without causing radiating pain as an indication of trigger points rather than tender points, then the patient had fibromyalgia syndrome, but if you experience less than this, it does not mean that you do not have FMS. Finally, whether or not your symptoms or pain have been consistently present for at least 3 months will need to be determined. These have been the guidelines for diagnosing FMS since 1990.
In 2010, preliminary changes to the diagnostic criteria for FMS were published by the College. These new criteria would use two scores, a Widespread Pain Index (WPI), which is determined by how many out of 19 areas of your body have pain, and a Symptom Severity (SS) scale, measured by your answers to a 42-question symptom survey. This would effectively eliminate the use of tender points in diagnosis, and likely make it possible for more people who do not have FMS to be diagnosed with it anyway since it is quite vague and generalized.
What’s the Prognosis?
There is no cure for FMS, but there are many medications, treatments, and therapies that can help with the pain and other symptoms. Unfortunately, since the cause is undetermined, one can only treat the symptoms rather than the problem itself, but that’s better than nothing. Those diagnosed with fibro have the option of taking pain medication or antidepressants, doing physical therapy, or trying alternative therapies such as chiropractic or massage, among other treatments.