Diagnosing Fibromyalgia
Fibromyalgia is an elusive illness with no known definite cause and no cure. I started this website because I know how exhausting it is to drag yourself from doctor to doctor in search of diagnosis, scouring the internet for answers and piecing together information. I want to offer Fibro Fighters, new and seasoned alike, families of those with FMS and everyone in between, 1 place. One place for trusted information;
for the diagnosed and for those in search, for Fibro Folk and for their families,
for research and news, and a place to connect.
Below is information about Diagnosing Fibromyalgia. The field of Fibromyalgia and Pain Management is only just starting to garner the respect, research and attention it deserves in the medical community. Because of this, I expect there will be more information and research available in near future than ever before. In this section, "Diagnosing the Ever Elusive: Fibromyalgia", I offer information based on the most current Diagnostics and most up-to-date Research.
Diagnosing Fibromyalgia can be a very long and involved process. For most patients it takes a matter of seeing many doctors over many years, before they are correctly diagnosed. Because the symptoms of pain and fatigue are similar to those of other disorders, it is important that diseases that can be tested for, and that mimic the behaviors of FMS, are ruled out. Additionally, Fibromyalgia sufferers are all commonly afflicted with things such as:
Migraine Headaches, Sleep Disturbances (such as Sleep Walking, Night Terrors), Irritable Bowel Syndrome, Chronic Fatigue (which occurs in 90% of patients), Dysmenorrhea, Cognitive Issues/Problems Concentrating (Known as Fibro Fog), Sensitivity to Light and Sound, Facial and Jaw Pain.
In Diagnosing Fibromyalgia, a physician will look for patients who present with acute pain (three months or longer), stiffness, and tenderness in all four quadrants of their body (widespread pain). Fibro does not cause deformity or damage to the body's tissue's and is not a progressive disease. What does this mean? While Fibromyalgia is an excruciating disorder that can cause flare-ups that last for months and in most patients is a fact of daily life, the pain and stiffness does not degenerate bones, tendons, ligaments, muscles/tissues or nerves. Fibro is not caused by and does not cause inflammation (which is why anti-inflammatory medications like Motrin don't work) and is not an auto-immune disease. Fibromyalgia will not progressively get worse with time, but that is not to say that flare-ups will not occur with stressful events and life changes.
The Traditional Tender Point Test
The American College of Rheumatology (ACR) developed criteria to diagnose fibromyalgia. Patients must have widespread pain for at least three months and the pain must be present in all four body quadrants (right and left sides and above and below the waist). Patients must also have pain in 11 of 18 tender points, which are specific areas that, when pressed gently, cause pain. Fibromyalgia may be diagnosed if a patient has fewer than 11 tender points if the patient also has widespread pain plus other symptoms of fibromyalgia. Below is The American College of Rheumatology Standard for Diagnosing Fibromyalgia
The American College of Rheumatology Has Established The Following 2 Criteria for Diagnosing Fibromyalgia:
The Anti-Polymer Assay Diagnostic
At this time there aren't any diagnostic lab tests approved in the United States by the F.D.A to confirm Fibromyalgia. There is however something called an Anti-Polymer Assay (APA Assay) diagnostic lab which detects IgG anti-polymer antibodies in human serum. Researchers do not fully understand the nature of these anti-bodies but recently published research has shown that fibromyalgia patients with higher levels of the anti-polymer antibodies in their blood have more severe fibromyalgia symptoms than patients with lower antibody levels. This test could potentially change the field of Pain Management by putting an end to the current climate of patients and their frustrating and endless journey to seek doctors who believe in Fibro. Experts are currently researching something called APA Assay that may be able to detect fibromyalgia in up to 50% of sufferers. While this may offer proof to some sufferers of Fibromyalgia, others will still have no definitive medical evidence of their disorder.
Brain Scans
Using brain scans on patients with fibromyalgia, researchers have discovered an abnormal increase in blood flow (called "brain perfusion") in an area of the brain that discriminates the intensity of pain, and a decrease in blood flow in areas thought to be involved in the emotional response to pain. These abnormalities were unrelated to the patients' depression and anxiety levels, reinforcing the idea that fibromyalgia is a real disorder, rather than a result of depression.
The Fibro Frustration: Be Your Own Advovate & Don't Take No For An Answer
Because it is so difficult to diagnose, often physicians become increasingly frustrated with the patient and the Fibro sufferer will become increasingly discouraged and frustrated, as well. In cases of Fibromyalgia, physicians will typically order Blood Tests, Urine Tests, X-Rays, CT-Scans (with and without Contrast), MRI, Ultrasounds, Bone Scans and more in a quest to find what ails their patient. With each test that comes back normal the physician and patient often both become more confused. Typically the patient is sent Specialist at this point and soon it becomes a game of Hot-Potatoe. Meanwhile, You are in endless, gnawing pain. In a lot of unfortunate cases, the physician will assume the patient is out to get a Rx for Painkillers - because as far as they can tell, the tests are all normal and the patient is bouncing from Doctor to Doctor without answers. In reality however, most Fibro Fighters are just following the Yellow Brick Road they have been sent on, going from Specialist to Specialist and hoping with every visit that they will have an answer as to why their entire body is under siege. I write this with personal experience and I write this as a warning: It is imperative that if you think you may have Fibromyalgia or if you already have been diagnosed, that you are treated by a knowledgeable, patient and caring Physician.Fibromyalgia was only introduced into the Medical Journals in 1990 and currently there is such limited research on it that treatment isn't even covered in Medical School.
Who Should you See? If you have not yet been diagnosed and suspect something is wrong and are in pain all the time, see a General Practitioner (GP) for a good starting point. They will be able to get your chart in order and refer you to the appropriate physician based on your symptoms. If you in fact have Fibromyalgia based on the conclusion of the GP you will be referred to a Rheumatologist or Pain Management Specialist. If you have already been diagnosed with FMS but are in a net of physicians (*It is extremely common to be bounced around to dozens of doctors, all with different specialties) and not sure which type is right for you, I highly recommend seeing a Rheumatologist or Pain Management Specialist. Fibromyalgia is considered a Rheumatic Disease and things like Lupus and Rheumatoid Arthritis (RA) are linked as underlying causes so we need to make sure a Qualified physician is in our corner and on our case, managing it. Pain Management is another direction as they often specialize in all things pain so if you suffer from Migraine Headaches (classic Fibro), your PM doctor will most likely be able to take on your entire file instead of seeing multiple doctors. Neurologists will be able to help you but only with your neuropathic pain - meaning the "zing-ing" pains and will see your pain through the lens of somebody who studies nerve-endings and then treat based on that. Your pain is much more complex than just that so while Neurologist's are great physicians it is important that if your pain-needs are not met, you move on.
for the diagnosed and for those in search, for Fibro Folk and for their families,
for research and news, and a place to connect.
Below is information about Diagnosing Fibromyalgia. The field of Fibromyalgia and Pain Management is only just starting to garner the respect, research and attention it deserves in the medical community. Because of this, I expect there will be more information and research available in near future than ever before. In this section, "Diagnosing the Ever Elusive: Fibromyalgia", I offer information based on the most current Diagnostics and most up-to-date Research.
Diagnosing Fibromyalgia can be a very long and involved process. For most patients it takes a matter of seeing many doctors over many years, before they are correctly diagnosed. Because the symptoms of pain and fatigue are similar to those of other disorders, it is important that diseases that can be tested for, and that mimic the behaviors of FMS, are ruled out. Additionally, Fibromyalgia sufferers are all commonly afflicted with things such as:
Migraine Headaches, Sleep Disturbances (such as Sleep Walking, Night Terrors), Irritable Bowel Syndrome, Chronic Fatigue (which occurs in 90% of patients), Dysmenorrhea, Cognitive Issues/Problems Concentrating (Known as Fibro Fog), Sensitivity to Light and Sound, Facial and Jaw Pain.
In Diagnosing Fibromyalgia, a physician will look for patients who present with acute pain (three months or longer), stiffness, and tenderness in all four quadrants of their body (widespread pain). Fibro does not cause deformity or damage to the body's tissue's and is not a progressive disease. What does this mean? While Fibromyalgia is an excruciating disorder that can cause flare-ups that last for months and in most patients is a fact of daily life, the pain and stiffness does not degenerate bones, tendons, ligaments, muscles/tissues or nerves. Fibro is not caused by and does not cause inflammation (which is why anti-inflammatory medications like Motrin don't work) and is not an auto-immune disease. Fibromyalgia will not progressively get worse with time, but that is not to say that flare-ups will not occur with stressful events and life changes.
The Traditional Tender Point Test
The American College of Rheumatology (ACR) developed criteria to diagnose fibromyalgia. Patients must have widespread pain for at least three months and the pain must be present in all four body quadrants (right and left sides and above and below the waist). Patients must also have pain in 11 of 18 tender points, which are specific areas that, when pressed gently, cause pain. Fibromyalgia may be diagnosed if a patient has fewer than 11 tender points if the patient also has widespread pain plus other symptoms of fibromyalgia. Below is The American College of Rheumatology Standard for Diagnosing Fibromyalgia
The American College of Rheumatology Has Established The Following 2 Criteria for Diagnosing Fibromyalgia:
- A history of widespread pain that has lasted over three months. Widespread means the pain affects the four parts (quadrants) of your body - the left, right, top and bottom sides.
- The presence of tender points in 18 sites of the body. These sites are located at the back and front of the neck, between the neck and chest, just below the neck on the back, the knees, the inside of the elbows, just above the buttocks (where two dimples are usually located), just below the buttocks at the top of the back thighs at their furthest point from the crotch. At least 11 of these points need to be tender for a fibromyalgia diagnosis to be confirmed. For a point to be tender the patient should feel pain if 4gk of pressure is applied to it. It is possible that a fibromyalgia patient feels pain at other points - however, for a diagnosis to be confirmed tenderness needs to be limited to those 18 points (at least 11 of them).
The Anti-Polymer Assay Diagnostic
At this time there aren't any diagnostic lab tests approved in the United States by the F.D.A to confirm Fibromyalgia. There is however something called an Anti-Polymer Assay (APA Assay) diagnostic lab which detects IgG anti-polymer antibodies in human serum. Researchers do not fully understand the nature of these anti-bodies but recently published research has shown that fibromyalgia patients with higher levels of the anti-polymer antibodies in their blood have more severe fibromyalgia symptoms than patients with lower antibody levels. This test could potentially change the field of Pain Management by putting an end to the current climate of patients and their frustrating and endless journey to seek doctors who believe in Fibro. Experts are currently researching something called APA Assay that may be able to detect fibromyalgia in up to 50% of sufferers. While this may offer proof to some sufferers of Fibromyalgia, others will still have no definitive medical evidence of their disorder.
Brain Scans
Using brain scans on patients with fibromyalgia, researchers have discovered an abnormal increase in blood flow (called "brain perfusion") in an area of the brain that discriminates the intensity of pain, and a decrease in blood flow in areas thought to be involved in the emotional response to pain. These abnormalities were unrelated to the patients' depression and anxiety levels, reinforcing the idea that fibromyalgia is a real disorder, rather than a result of depression.
The Fibro Frustration: Be Your Own Advovate & Don't Take No For An Answer
Because it is so difficult to diagnose, often physicians become increasingly frustrated with the patient and the Fibro sufferer will become increasingly discouraged and frustrated, as well. In cases of Fibromyalgia, physicians will typically order Blood Tests, Urine Tests, X-Rays, CT-Scans (with and without Contrast), MRI, Ultrasounds, Bone Scans and more in a quest to find what ails their patient. With each test that comes back normal the physician and patient often both become more confused. Typically the patient is sent Specialist at this point and soon it becomes a game of Hot-Potatoe. Meanwhile, You are in endless, gnawing pain. In a lot of unfortunate cases, the physician will assume the patient is out to get a Rx for Painkillers - because as far as they can tell, the tests are all normal and the patient is bouncing from Doctor to Doctor without answers. In reality however, most Fibro Fighters are just following the Yellow Brick Road they have been sent on, going from Specialist to Specialist and hoping with every visit that they will have an answer as to why their entire body is under siege. I write this with personal experience and I write this as a warning: It is imperative that if you think you may have Fibromyalgia or if you already have been diagnosed, that you are treated by a knowledgeable, patient and caring Physician.Fibromyalgia was only introduced into the Medical Journals in 1990 and currently there is such limited research on it that treatment isn't even covered in Medical School.
Who Should you See? If you have not yet been diagnosed and suspect something is wrong and are in pain all the time, see a General Practitioner (GP) for a good starting point. They will be able to get your chart in order and refer you to the appropriate physician based on your symptoms. If you in fact have Fibromyalgia based on the conclusion of the GP you will be referred to a Rheumatologist or Pain Management Specialist. If you have already been diagnosed with FMS but are in a net of physicians (*It is extremely common to be bounced around to dozens of doctors, all with different specialties) and not sure which type is right for you, I highly recommend seeing a Rheumatologist or Pain Management Specialist. Fibromyalgia is considered a Rheumatic Disease and things like Lupus and Rheumatoid Arthritis (RA) are linked as underlying causes so we need to make sure a Qualified physician is in our corner and on our case, managing it. Pain Management is another direction as they often specialize in all things pain so if you suffer from Migraine Headaches (classic Fibro), your PM doctor will most likely be able to take on your entire file instead of seeing multiple doctors. Neurologists will be able to help you but only with your neuropathic pain - meaning the "zing-ing" pains and will see your pain through the lens of somebody who studies nerve-endings and then treat based on that. Your pain is much more complex than just that so while Neurologist's are great physicians it is important that if your pain-needs are not met, you move on.