Fibromyalgia: The Right Or Wrong Diagnosis?

February 4, 2009 by admin · Leave a Comment
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Because of a multifaceted treatment approach that involves medications and lifestyle strategies, the prognosis for people with fibromyalgia syndrome is better than ever before. But first, a doctor needs to make an accurate diagnosis of fibromyalgia.  Are you wondering how that is done?   Unfortunately, fibromyalgia is regularly misunderstood.  Despite all the latest information about fibromyalgia with its severe muscle pain, unrelenting fatigue and sleep problems, and feelings of anxiety and depression, doctors are still misdiagnosing this common pain disorder – fibromyalgia. As a result, some patients are getting a diagnosis for the wrong condition for example, chronic fatigue syndrome, arthritis, or some other pain problem.

What is fibromyalgia?  Fibromyalgia is a syndrome with multiple symptoms that commonly occur together, including widespread pain, decreased pain threshold or trigger points, incapacitating fatigue, and anxiety or depression.

Why is diagnosing fibromyalgia difficult?  It takes on average 5 years for a person with fibromyalgia to get an accurate diagnosis. Some people go from doctor to doctor without receiving a medical diagnosis for their fibromyalgia symptoms.  Many wonder if their painful symptoms are simply imagined.  There are no scientific measures, such as laboratory tests or x-rays, that "prove" you have fibromyalgia. In the past, millions of fibromyalgia patients were misdiagnosed as having depression, a type of inflammatory arthritis such as rheumatoid or lupus, chronic myofascial pain, or chronic fatigue syndrome.  There are, of course, a few similarities between fibromyalgia and chronic fatigue syndrome or fibromyalgia and arthritis. However fibromyalgia is different. Fibromyalgia is a distinct condition that needs an accurate diagnosis and appropriate treatment.

What tests will my doctor use to diagnose fibromyalgia syndrome?  Most laboratory tests are not very useful by themselves for diagnosing fibromyalgia syndrome. Your physician will come to a diagnosis after doing a physical examination and discussing your symptoms with you.  The reason for this is that a diagnosis to large extent is based on the way you feel. For instance, even though your doctor may notice trigger points during the physical examination, you still need to tell him or her about the pain you feel in those areas.   Your doctor will use a few laboratory tests to make sure you do not have a more serious medical condition.  These tests can probably be done during one visit to a laboratory.

What specific tests will my doctor ask for?  Among the specific blood tests that your doctor may order is a complete blood count (CBC).  This test measures the hemoglobin, red cells, white cells, and platelets.  It can also find many common blood disorders such as anemia that can cause fatigue.   Your doctor may ask for tests including kidney and liver tests that check blood chemistries. Your doctor will probably want to know the level of cholesterol and other fats in your blood, calcium levels, and more.  In addition, your doctor may run thyroid tests to see if your thyroid is overactive or underactive.

Will my doctor test for inflammatory arthritis?   Doctors who diagnose fibromyalgia usually test the red blood cell sedimentation rate and this test provides a rough index of inflammation in the body. In rheumatoid and other similar types of arthritis, this test is abnormal.  It can also be abnormal with some infections.  In cases of osteoarthritis and fibromyalgia, however, it is usually normal.   Your doctor might test for rheumatoid factor.  This blood test measures an abnormal protein in the blood and is positive for 70 to 80 percent of patients with rheumatoid arthritis. But this blood test can also be positive in healthy individuals and is sometimes negative in people with rheumatoid arthritis.   Your doctor may also test for anti-nuclear antibody (ANA). Like rheumatoid factor, ANA is an abnormal protein in the blood and it is commonly found with systemic lupus.  Lupus is more common in women, especially younger women, and can cause pain and fatigue.  Lupus may also cause internal organ problems, such as kidney disease, heart disease, or problems in the brain.

Can X-rays show problems with fibromyalgia syndrome?   With fibromyalgia, x-rays of painful areas will show no abnormality. If you have another problem, such as arthritis, then there may be some abnormalities on the x-rays to indicate what type of arthritis you have. Remember any x-ray changes are not due to fibromyalgia.

Will my doctor know which tests might rule out serious problems?   Talk openly with your doctor in order to understand the overall results of the diagnostic process. Ask your doctor to explain the findings from the physical examination, the laboratory testing, and the x-rays. Doing so will help you understand your fibromyalgia.  Be sure to ask questions about fibromyalgia, its symptoms, and your treatment options.

What are the latest diagnostic guidelines for fibromyalgia?  After ruling out another serious medical problem, your doctor will consider whether or not your condition meets two criteria:

1. Has there been widespread pain in all four quadrants of your body for a minimum of three months?
2. Do you have tenderness or pain in at least 11 of 18 specific tender points when pressure is applied?

What other problems will my doctor assess in diagnosing fibromyalgia?   To be thorough in making a diagnosis of fibromyalgia, your doctor will do the following six things: check for widespread pain, evaluate trigger points, ask about fatigue, inquire about sleep disturbances, evaluate your level of stress, and test for depression.

What happens if I am diagnosed with fibromyalgia?   Your doctor will discuss a multifaceted treatment program with you.  That program includes medications, exercise, stress reduction, sleep strategies, and more.  Staying on this program will help alleviate your fibromyalgia symptoms so you can reclaim an active life and do the things you want to do.

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  • How to Treat Fibromyaglia

    There are plenty of ailments which affect people regardless of their age. Knee pain and muscle sprains for example are among those problems which affect people of all ages. But there is another ailment that all people should be wary of and that is Fibromyalgia, an ailment which affects various sets of muscles in the body and not just any single one. Some symptoms include pain, headaches, weariness and in some cases even digestive trouble.
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