Diagnosing Fibromyalgia: Tests and Procedures
If you’ve had muscle pain, extreme tiredness, and tender points—places on your body that are painful to touch—visit with your doctor. These are all symptoms of fibromyalgia. If you suspect that you may have fibromyalgia, patience is key when starting the evaluation process. Because the pain and fatigue associated with fibromyalgia is common to many other health conditions, a fibromyalgia diagnosis is often a process of elimination.
What kind of doctor diagnoses and treats fibromyalgia?
Many people with fibromyalgia are misdiagnosed with arthritis, chronic fatigue syndrome, depression, or some other type of pain-related condition. You’ll want to see a doctor experienced in diagnosing and treating fibromyalgia—ideally a rheumatologist. A rheumatologist specializes in arthritis, autoimmune conditions, and pain disorders. However, many family doctors, internists, and neurologists have experience with fibromyalgia. You can also contact the National Fibromyalgia Association and see if they can suggest someone in your area.
Your doctor will take your medical history and perform a physical exam.
During the physical exam, your doctor will check for tender points on your body by applying pressure to certain areas. Let your doctor know about all of your symptoms and concerns.
You can help your doctor by:
Compiling a medical history. Before you go to your appointment, make a list of your symptoms, when you notice them the most, and your personal and family health history.
Keeping track of your symptoms in a log. Your doctor may want you to keep a record of your symptoms. Think about when they occur, how long they last, what you were doing and your activity level around the time they occur, and how much pain you have on a scale of 1 to 10. Also log the amount of sleep you get each night.
Is there a fibromyalgia test?
Unfortunately, there aren't any lab tests or imaging studies that can specifically pinpoint fibromyalgia. Nevertheless, your doctor will probably order blood tests to rule out conditions with symptoms similar to fibromyalgia, such as arthritis, thyroid disease, Lyme disease, lupus, and muscle or nerve disorders.
Blood tests may include:
Complete blood count (CBC) to look for anemia and white or red blood cell abnormalities
Comprehensive metabolic panel (CMP) to examine electrolytes, proteins, liver and kidney function, calcium, and glucose
Thyroid function test to check for hypothyroidism, which can cause symptoms similar to fibromyalgia
Anti-nuclear antibody (ANA) test to check for an autoimmune disorder such as lupus
Creatine kinase (CK) test to look for conditions that cause muscle weakness or pain
Red blood cell (erythrocyte) sedimentation rate (ESR) to check for inflammation in the body
Depending on your personal medical history and symptoms, it’s possible your doctor may order an X-ray or recommend an MRI to rule out other conditions, such as multiple sclerosis. Talk with your doctor about all of your test results.
How does your doctor diagnose fibromyalgia?
After ruling out other conditions, your doctor will consider whether your symptoms meet the criteria for fibromyalgia created by the American College of Rheumatology, which include having:
Pain in all four quadrants of your body (the left and right side; above and below the waist) lasting longer than three months. The pain is often described as a dull but constant pain coming from the muscles.
Tenderness or pain to touch in at least 11 of 18 specific tender points when pressure is applied. Tender points include your hips, front of the neck, and between your shoulder blades.
The criteria for diagnosing fibromyalgia are a guideline. Many people with fibromyalgia experience pain all over their body, not just at specific tender points. Regardless of these limitations, doctors can diagnose fibromyalgia based solely on your symptoms if they cannot determine another underlying cause of your pain.