Fibromyalgia is a chronic disease characterized by body-wide pain, tenderness and exhaustion.
While the disease is often grouped into the same category as arthritis, it does not cause harm to joints or other tissue.
Instead of being caused by inflammation, it is commonly recognized that fibromyalgia is a central nervous system disease— meaning the brain is over-sensitive to signals of pain.
Symptoms of fibromyalgia may vary in intensity and may enhance or deteriorate over time. The severity of your symptoms can be affected by factors such as stress, climate changes, too much or too little practice and too much or too little rest. Fibromyalgia symptoms may include:
- Widespread pain that occurs on both sides of the body, above and below the tail
- Tenderness to touch
- Fatigue, despite sufficient rest
- Difficulty dropping or sleeping
- Stiffness in the morning or increased pain in the morning
- Memory or concentration difficulties (known as “fibro fog”)
- Problems with vision
- Balance or coordination problems
- Tingling or numbness in your hands or feet
- Temperature sensitivity (heat or cold)
- Bright light sensitivity or loud noise
- Painful periods of menstruation in females
- Pain in your face or in your jaw
- Headaches such as migraines
- Digestive problems, including pain in the abdomen, bloating, or constipation
- Bladder problems
- Mouth or dry eyes
- Sensitivity to the skin or rash
Tender points for fibromyalgia
Tender points of fibromyalgia— also known as trigger points — are regions of the body that often cause pain.
People with fibromyalgia often say that when you press them with a finger, these areas hurt.
There are 18 tender points (nine pairs) recognized that, when pressed, tend to be painful.
These spots are frequently discovered around the elbows, shoulders, knees, neck, hips, breastbone sides, and back of the head on both sides of the body.
Diagnostic fibromyalgia challenges
Because many of its symptoms are comparable to those of other illnesses, fibromyalgia can be hard to diagnose.
A diagnosis often needs other circumstances to be excluded, rather than finding definitive evidence that you have fibromyalgia.
According to Don L. Goldenberg, MD, a rheumatologist and emeritus professor of medicine and nursing at Oregon Health and Science University in Portland, in someone with fibromyalgia, “There is very little to see on a physical examination,” other than reported pain and tenderness.
Moreover, “Laboratory experiments are not remarkable,” and physicians often offer little assistance, suggests Dr. Goldenberg.
Before you get an precise diagnosis, you may end up seeing several physicians. According to Goldenberg, this method may last longer than it should due to errors made by both physicians and patients.
“Many patients will shop from physician to doctor with this disease,” he claims. “They’re sure they’ve been wounded or harmed, or their environment has something to do with them. And they keep looking and looking. “According to Goldenberg, a diagnosis of fibromyalgia involves accepting that your pain has no cause beyond the nervous system itself— and may therefore be harder to treat.
At the same moment, by either being too deferential to — or too dismissive of— patients, physicians can prolong the diagnostic process, Goldenberg suggests.
“Many physicians are going to order many unnecessary exams,” he notes, owing to the willingness of patients to rule out unlikely causes of their pain.
But more frequently, “Doctors are going to say,’ Toughen up is all in your head,'” laments Goldenberg. “And of course that’s the last thing a person wants to hear.” While Goldenberg doesn’t excuse such conduct in physicians, he knows why some of them respond to fibromyalgia so badly.
“This is a true gray area for a certain sort of doctor who loves black and white stuff,” he suggests. “There is no cause or effect. The symptoms may be gloomy. The therapy is very gloomy.
How to diagnose fibromyalgia
While there is no definitive test for fibromyalgia diagnosis, the American College of Rheumatology (ACR) has created requirements for disorder identification.
In the past, physicians would inspect the body’s 18 tender points to determine the amount of pain of a person. Current guidelines do not require this type of examination.
Rather, the ACR instructs physicians to take into account the following variables:
- How many areas of the body are painful (out of 18)
- Whether there are symptoms such as fatigue, unrefreshed awakening or trouble thinking
- Whether these symptoms lasted for at least three months
- Whether any other disease could be responsible for these symptoms
Finding a doctor who is acquainted with fibromyalgia is crucial. The disorder can be correctly diagnosed and treated by many rheumatologists, internists, and family doctors. You may want to write a list before you see your doctor that involves:
- All medical conditions in the past and now
- Your symptoms are described in detail
- Your family’s medical circumstances
- You are taking all medications and supplements
- Any questions that you would like to ask your physician
Ruling Out of Other Conditions
Even if your doctor suspects that you have fibromyalgia, it may be desirable to rule out other, more serious conditions.
For example, “Wide-spread arthritis can cause pain in multiple areas,” Goldenberg notes. But, he adds, “Most doctors, though not all of them, should clearly be able to see that.”
If your doctor is not prepared to diagnose fibromyalgia on the basis of your symptoms and a physical exam alone, the following tests may be helpful:
Complete Blood Count This test may help to rule out a number of disorders, including anemia (inadequate red blood cells), infection, and leukemia.
Erythrocyte Sedimentation Rate (ESR, or Sed Rate) This test may help to detect inflammatory processes throughout your body.
Cyclic Citrullineated Peptide and Rheumatoid Factor These tests may help detect rheumatoid arthritis.
Thyroid function In some cases, it may be helpful to rule out thyroid problems as the cause of your symptoms.