Do I Have Fibromyalgia?

Do I Have Fibromyalgia - Fibromyalgia Tender Points

  Fibromyalgia is still a very mysterious disorder with no laboratory tests to confirm its existence and no treatments to cure its symptoms. The condition is generally characterized by chronic, widespread joint and muscle pain without inflammation.

  Before fibromyalgia treatment can begin, a doctor must diagnose the condition. Experts think that fibromyalgia is underdiagnosed because many of its symptoms are the same as those of other conditions (such as chronic fatigue syndrome, underactive thyroid, Lyme disease, lupus, and multiple chemical sensitivity). Therefore, doctors often must rule out other possible causes of these symptoms before officially diagnosing.

  To determine if you’re one of the estimated 10 million Americans who have fibromyalgia, you need to take note of the location and severity of your pain, as well as any of several other symptoms that are commonly associated with the condition.

1. Location of pain: If you have fibromyalgia, your pain isn’t confined to one area of your body. It’s located in muscles, ligaments, tendons, and joints on your left and right sides, as well as above and below your waist. A doctor who suspects you have fibromyalgia will squeeze several tender points on your body to see if they hurt when pressure is applied. These tender points are located in the front and back of your neck, upper chest and back, hips, buttocks, elbows, and knees. (see image)


2. Duration of pain: Fibromyalgia is a chronic condition. Although the intensity of your aches may vary from one day to the next, if you have fibromyalgia you will suffer from some level of pain consistently for at least 3 months. If you’re experiencing this type of chronic pain, be sure and discuss these symptoms with your doctor. Fibromyalgia can be mistaken for, or exist side-by-side with, other diseases, including rheumatoid arthritis, lupus, or hypothyroidism.


3. Fatigue and sleep disturbances: Exhaustion is a common complaint among fibromyalgia sufferers. On some days, you may find that your fatigue is so severe you can’t accomplish what you need to get done, even though you slept through the night. Researchers believe fibromyalgia sufferers may not be able to fall into a deep enough so that they wake up feeling rested. Restless leg syndrome and sleep apnea are also sleep disorders common among fibromyalgia sufferers.


4. Delayed reactions to physical exertion or stressful events: Feeling OK during and immediately after exercise, only to have symptoms come on strong later, or getting through a crisis, but then crashing within a couple of hours.


5. Unusual Symptoms:  You may be more comfortable with your diagnosis after looking over a list of unusual symptoms and seeing whether you identify with a large number of them. You don't have to have all of them to have fibromyalgia, but you should have more than a handful to lend credence to the diagnosis. 

• Allodynia: Pain from pressure, temperature or movement across your skin that should not be painful.
• Language impairments: These can include forgetting common words (especially nouns) or having trouble putting a sentence together.
• Paresthesia: Tingling or burning sensations in the hands or arms, without any known nerve damage.
• Roving pain: Pain that seems to wander randomly around your body instead always being in the same place(s).
• Sensory overload: Strong reactions to repetitive noises (noise sensitivity), bad smells, bright or flashing light (light sensitivity), or chaotic environments.
• Headaches: For more than 50 percent of fibromyalgia sufferers, the condition brings recurring tension headaches and migraine pain.
• Irritable bowel syndrome: You may also be experiencing diarrhea, constipation, abdominal pain and bloating, and nausea. At least 40 percent of people with fibromyalgia have digestive problems.

  While many chronic pain syndromes mimic certain aspects of fibromyalgia, the 1990 American College of Rheumatology criteria identifies fibro patients with an 88 percent accuracy. This is just as accurate as blood tests for other medical conditions, so you and doctors should not view fibromyalgia as a wastebasket diagnosis.

  Under newer, alternate diagnostic criteria established in 2010, your doctor may first have to read a long list of body parts or give you a written list and have you indicate where you've had pain in the last week, ranking the severity of multiple symptoms from 0-3. The doctor then looks at your totals to determine whether you have fibromyalgia.

  A doctor who knows about fibromyalgia, can make a diagnosis based upon two criteria:

1. A history of widespread pain in all four quadrants of the body lasting more than 3 months. Pain must be present in both the right and left sides of the body as well as above and below the waist.


2. Presence of 11 tender points. The body has 18 sites that are possible tender points. For fibromyalgia diagnosis a person must have 11 or more tender points. For a point to be “tender,” the patient must feel pain when pressure is put on the site. People who have fibromyalgia may feel pain at other sites, too, but those 18 sites on the body are used for diagnosis. (see image)

  If your doctor didn't use either of these methods, you may be wise to question the diagnosis and should consider seeking another opinion. If your doctor did use one of these methods, and ruled out other causes, it's highly likely that you have fibromyalgia.

  Your doctor may try to rule out other causes of your pain and fatigue. Testing for some of these things may make sense to you. For instance, you may find it reasonable that your doctor wants to rule out rheumatoid arthritis, since that disease also causes pain. Testing for other conditions — such as lupus, multiple sclerosis, or sleep apnea — may make less sense to you. But fibromyalgia can mimic or even overlap many other conditions. Talk with your doctor. He or she can help you understand what each test is for and how each test is part of making a final diagnosis.

  If you go through all of this and believe you're misdiagnosed, you should talk to your doctor or consider seeing a specialist, such as a rheumatologist or neurologist.


     All statements here are not claims to cure or treat any disease, provide any health benefit, and are for educational and thoughtful purposes only. If you need medical advice, please seek a qualified health care provider.