How is Fibromyalgia Diagnosed?

You could call fibromyalgia a copycat condition. Its main symptoms -- widespread pain and fatigue -- are a lot like those of other health problems. And there’s no test or scan that can diagnose fibromyalgia, so it can be hard for your doctor to nail down what’s causing your aches and pains.

If you think you could have it, pack your patience. You may need to see several doctors to get the right diagnosis. Once you do, the right treatments can help you feel better.

First Steps

Your family doctor may be able to tell you have fibromyalgia if they’re familiar with the condition. But you’ll probably want to see a rheumatologist, a doctor who’s an expert in problems with joints, muscles, and bones.

Your rheumatologist will ask you about your health and family history -- you’re more likely to have fibromyalgia if other people in your family have it.

They’ll give you a physical exam and may check for tender points. People who have fibromyalgia often feel tenderness when pressure is put on certain spots, generally around the back of your head, your neck, shoulders, elbows, knees, and hips.

They’ll also ask about your symptoms, so it’s a good idea to keep a detailed record of where and when you hurt. Is the pain dull or sharp? Does it come and go, or is it constant? Are you tired a lot or not thinking clearly? Write down any other problems you have, even if you don’t think they’re related.

Fibromyalgia or Something Else?

Several conditions cause pain, muscle aches, and fatigue, just like fibromyalgia:

• Hypothyroidism: Your thyroid gland doesn’t make enough of a certain hormone.
• Rheumatoid arthritis or lupus: Problems with your immune system cause swelling and pain.
• Osteoarthritis: This is the “wear and tear” type of arthritis.
• Ankylosing spondylitis: This is a specific type of arthritis that causes pain and inflammation in your spine.
• Polymyalgia rheumatica: This disorder causes widespread pain and stiffness that come on quickly.

Your doctor will want to rule out any of these other problems. They may take a sample of your blood to check your hormone levels or look for signs of inflammation. You may also get X-rays so they can look at your bones.

Fibromyalgia Scoring System

If your doctor can’t find another reason for your symptoms, they’ll use a two- part process to help figure out if you have fibromyalgia. One part involves the trademark widespread pain on both sides of your body and above and below your waist. The other part measures how bad your symptoms are.

They’ll ask if you’ve had pain in 19 specific places in the past week, including your arms, legs, back, jaw, and neck. This is called the widespread pain index (WPI), and scores range from 0 to 19.

The symptom severity (SS) scale measures three key symptoms during the past week:

• Fatigue
• Waking up still tired
• Thinking problems

The SS scale ranges from 0 to 3:

• 0 -- No problems
• 1 -- Mild: It comes and goes.
• 2 -- Moderate: You usually have or feel it.
• 3 -- Severe: It seriously affects your daily life.

Your doctor also will ask if you’ve had about 40 other symptoms that can affect people who have fibromyalgia. These include depression and anxiety, bellyaches, itching, taste changes, numbness, and dizziness. This score ranges from 0 (no symptoms) to 3 (a lot of problems).

Your doctor will add all the SS numbers together to get a score. It will be between 0 and 12.

Your doctor may tell you that you fibromyalgia if you:

• Have a WPI score of 7 or more and SS score of 5 or more
• Have WPI of 3 to 6 and an SS score of 9 or more
• Have had symptoms at the same level for at least 3 months
• Don’t have any other condition that can cause these symptoms

From there, you’ll talk about a plan to manage it. With the right treatment, most people who have it live a normal, active life.

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