Fibromyalgia Diagnosis

  • Diagnosis

    Your doctor will do a complete medical history and conduct a physical examination to learn about your symptoms, and to rule out other disorders that could also explain your problems.

    Your doctor will press on 18 points on your body Figure 01. There are 18 “tender points” on your body that your doctor will press to test for pain. If you have fibromyalgia, you will feel pain when then doctor presses on at least 11 of these 18 points. If you don't have pain in these 18 specific spots, however, you still could have fibromyalgia.

    There is no laboratory test for fibromyalgia. If you have severe and persistent fatigue, however, your doctor may order serum thyroxine and thyroid-stimulating hormone tests to rule out the possibility that thyroid abnormalities are causing your symptoms. Other routine screening tests might include a complete blood count, an erythrocyte sedimentation rate, and a chemical profile.

    Fibromyalgia is a condition characterized by chronic, widespread musculoskeletal pain and tenderness, restless sleep, and fatigue. Fibromyalgia is caused by a generalized disturbance in pain processing that leads to pain in muscles and soft tissue. Fibromyalgia is common, and occurs in about 3.4% of women and 0.5 % of men. Fibromyalgia occurs in all types of climates, nearly all countries, and in most ethnic groups.

    Fibromyalgia is a physical condition, not a psychiatric illness. Fibromyalgia has only recently been recognized as a distinct physical condition. However, fibromyalgia patients with chronic symptoms may have psychological problems. In one study, 30% to 40% of people with fibromyalgia and its related conditions were found to suffer from depression, anxiety, or stress. While painful, fibromyalgia is not a form of arthritis, and therefore does not actually damage joints or other bodily tissue. With proper treatment, many patients can experience substantial relief.

    While there is no known cure for fibromyalgia, it is possible to keep your symptoms under control. The best way to treat fibromyalgia is with a combination of medication, self-care, and alternative treatment. It is usually not necessary to stop working, although you should be careful not to get too stressed or overtired.

    There is no known cause for fibromyalgia. However, people who suffer from fibromyalgia tend to share certain nervous system abnormalities that amplify and spread pain, and intensify other sensations. However, because many patients with fibromyalgia have disrupted sleep, there is thought to be a link between the condition and sleep disorders. Other factors that have been found to contribute to the condition are stress, chemical imbalances in the brain and spinal cord (such as improper levels or the brain chemical serotonin), and abnormalities in the immune or endocrine systems.

    Fibromyalgia may have a genetic link.

    Widespread pain and stiffness are the most common symptoms of fibromyalgia Table 01. If you have fibromyalgia, you will most likely feel pain in all four limbs, your spine, and chest wall. Other common symptoms are poor sleep, fatigue, swelling in the soft tissue (especially the hands), numbness in the extremities, headaches, restless leg syndrome, and irritable bowel symptoms. Joints may be tender to the touch, and pain may limit range of motion. Other symptoms include jaw pain, memory impairment, menstrual cramping, dizziness, sensitive skin, and chemical sensitivities. It has become clear that considerable overlap exists between fibromyalgia and chronic fatigue syndrome, migraine headaches, irritable bowel syndrome, tempromandibular joint syndrome, and mitral valve prolapse syndrome.

    Most people with this condition complain of aching and stiffness around the neck, shoulders, upper and lower back, and hip Figure 01. Tenderness on compression in 11 out of 18 specific sites called "tender points" is the hallmark of fibromyalgia. People suffering with fibromyalgia may also experience tingling or numbness in the extremities, or tension headaches. They may have no underlying disorders, or may have such conditions as rheumatoid arthritis, Lyme disease, spinal arthritis, or irritable bowel syndrome.

    Click to enlarge: Eighteen tender points in fibromyalgia

    Figure 01. Eighteen tender points in fibromyalgia

    Table 1.  Symptoms of Fibromyalgia

    Widespread pain
    Stiffness
    Poor sleep
    Fatigue
    Swelling in soft tissue (especially hands)
    Numbness in the extremities
    Headaches
    Restless leg syndrome
    Diarrhea
    Abdominal pain
    Tender joints
    Limited range of motion
    Jaw pain
    Memory impairment
    Menstrual cramping
    Dizziness
    Skin and chemical sensitivities

    Fibromyalgia is much more likely to affect women. The overwhelming majority of people with this condition (85%-90%) are women between the ages of 40 and 60.

    Trauma, physical exertion, overuse, humid or cold weather, stress, and poor sleep may aggravate symptoms.

    Your doctor will do a complete medical history and conduct a physical examination to learn about your symptoms, and to rule out other disorders that could also explain your problems.

    Your doctor will press on 18 points on your body Figure 01. There are 18 "tender points" on your body that your doctor will press to test for pain. If you have fibromyalgia, you will feel pain when then doctor presses on at least 11 of these 18 points. If you don't have pain in these 18 specific spots, however, you still could have fibromyalgia.

    There is no laboratory test for fibromyalgia. If you have severe and persistent fatigue, however, your doctor may order serum thyroxine and thyroid-stimulating hormone tests to rule out the possibility that thyroid abnormalities are causing your symptoms. Other routine screening tests might include a complete blood count, an erythrocyte sedimentation rate, and a chemical profile.

  • Prevention and Screening

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