How Doctors Make a Fibromyalgia Diagnosis
Doctors can't make use of standard laboratory testing to make an accurate fibromyalgia diagnosis. For this reason medical practitioners must make use of physical examination and thorough history taking to diagnose this painful and distressing condition. To make matters worse there are some doctors who don't accept the condition as a valid syndrome and may dismiss your pleas for help as being related to depression and anxiety which might co-exist with or be caused by your chronic pain.
Medical professionals who are familiar with fibromyalgia diagnosis examine a set of 'trigger or tender points' in the body to determine if these are sensitive to pressure. In order to make diagnosis of fibromyalgia the patient must show evidence of:
1) Pain in all four quadrants of the body for three months or longer and 2) pain in at least eleven of the eighteen critical tender points. These points are located in the neck, shoulder, chest, hip, knee, and elbow. In fact there are 75 known trigger points but these aren't used in fibromyalgia diagnosis.
In 1990 the ACR multi-center criteria study (published in the February 1990 issue of Arthritis and Rheumatism) examined 558 patients. The participants were age and sex matched and had neck pain, low back pain, local tendonitis, trauma pain symptoms, rheumatoid arthritis, lupus, osteoarthritis of the knee or hand, and other painful disorders. Trained examiners were able to distinguish their fibromyalgia diagnosis from symptoms of other disorders using trigger points.
Other symptoms may also occur and these are used in fibromyalgia diagnosis even in the absence of the eleven trigger points. Symptoms include: fatigue, irritable bowel, sleep disorder or lack of refreshing sleep, chronic headaches (tension-type or migraines), jaw pain (including TMJ dysfunction), cognitive or memory impairment, post-exertion malaise and muscle pain, morning stiffness, menstrual cramping, numbness and tingling sensations, dizziness or light-headed feelings and skin and chemical sensitivities.
There is some overlap between chronic fatigue symptom and fibromyalgia and different diagnostic criteria apply to each condition. However, some experts you may encounter will see them as one and the same. Fibromyalgia is typically seen as being different from CFS by most general practitioners and specialists. Fibromyalgia diagnosis accounts for about 2% of the general population while chronic fatigue syndrome accounts for only about 0,5%.
