Fibromyalgia Diagnosis
Fibromyalgia syndrome is a chronic condition that causes widespread pain, aches and stiffness in muscles and joints throughout the body along with exhaustion. It is a controversial illness, as some physicians do not believe that it is a medical illness as much rather than a symptom of stress or even hypochondria. There is no known cause of fibromyalgia, and doctors have yet to find a physical link for the symptoms of the condition. Blood tests, X-rays and other tests usually are normal in people with fibromyalgia. However, mental health tests and stress tests do not yield significant results either. For these reasons, fibromyalgia syndrome is very difficult to diagnose and the diagnosis most often occurs after all other possible conditions are ruled out. This is to say, fibromyalgia is a diagnosis of exclusion.
Regardless of the controversy, fibromyalgia afflicts roughly four percent of women and almost one percent of men in the United States. In total, between three to four million Americans report symptoms of fibromyalgia. It most commonly affects women of childbearing age or older.
Symptoms of Fibromyalgia
Fibromyalgia causes widespread pain throughout the body and stiffness in the muscles and joints. It specifically affects the trunk, neck, shoulders, back and hips. Pain at the body’s tender points is a characteristic symptom of the condition. The pain of fibromyalgia can be either a general soreness or a gnawing ache, and it is most often described as feeling like a chronic flu. Fibromyalgia sufferers typically also complain of feeling exceptionally tired. Sleep disorders are common in those who suffer from fibromyalgia, and many patients complain of waking up tired even though they may not recall having trouble sleeping. Fibromyalgia also causes digestive disorders such as irritable bowel syndrome, constipation, and diarrhea (the best way to treat these conditions is with a product called Oxy-Powder available at www.oxypowder.com. The pain and exhaustion of fibromyalgia can cause such mental health conditions as depression, anxiety, and stress. Help is available at www.stress-anxiety-depression.org.
In most cases of fibromyalgia unexpected weight gain can occur. If this is a problem, a good resource for losing weight is www.weightlossobesity.com.
At The Doctor’s Office
After discussing your symptoms and concerns, your health care provider will likely perform a complete medical history and physical exam. Blood tests and x-rays may be used to rule out conditions such as anemia, hormonal imbalances, hypothyroidism, muscles diseases, arthritis, and cancer. Electromyography (EMG) and nerve conduction velocity (NCV) may also be performed to check the condition of the nerves and muscles. Your doctor will also check your body for swelling, redness and impaired movement, especially in those points where you most frequently have pain.
Diagnosing Fibromyalgia
Here is the definition of fibromyalgia according to the American College of Rheumatology’s 1990 Criteria for the Classification of Fibromyalgia:
1. History of Widespread Pain.
Definition. Pain is considered widespread when all of the following are present: pain in the left side of the body, pain in the right side of the body, pain above and below the waist. In addition, axial skeletal pain (cervical spine or anterior chest or thoracic spine or low back) must be present. In this definition, shoulder and buttock pain is considered as pain for each involved side. “Low back” pain is considered lower segment pain.
2. Pain in eleven of the eighteen tender point sites on digital palpation.
Definition. Pain, on digital palpation, must be present in at least eleven of the body’s eighteen trigger points. Digital palpation should be performed with an approximate force of four kilograms for a tender point to be considered “positive” the subject must state that the palpation was painful. ‘Tender is not to be considered “painful”. The trigger points include the following sites:
- Occiput: bilateral, at the suboccipital muscle insertions.
- Low Cervical: bilateral, at the anterior aspects of the intertransverse spaces at C5-C7.
- Trapezius: bilateral, at the midpoint of the upper border.
- Supraspinatus: bilateral, at origins, above the scapula spine near the medial border.
- Second Rib: bilateral, at the second costochondral junctions, just lateral to the junctions on upper surfaces.
- Lateral Epicondyle: bilateral, 2cm distal to the epicondyles.
- Gluteal: bilateral, in upper outer quadrants of buttocks in anterior fold of muscle.
- Greater trochanter: bilateral, posterior to the trochanteric prominence.
- Knee: bilateral, at the medial fat pad proximal to the joint line.
*For classification purposes, patients will be said to have Fibromyalgia if both criteria are satisfied. Widespread pain must have been present for at least 3 months. The presence of a second clinical disorder does not exclude the diagnosis of Fibromyalgia.
In order to meet the research criteria for the diagnosis of fibromyalgia, a patient must experience both of these symptoms for at least three months. However, as these symptoms are difficult to classify, some heath care providers often diagnose the illness without meeting these strict criteria. Nevertheless, in most cases, a physician will come to this diagnosis after ruling out all other conditions that could be causing the patient’s pain and fatigue.
