The pain is real!

Diagnosing fibromyalgia can be challenging because there are no specific laboratory tests or imaging studies that can definitively confirm the condition. Instead, it is primarily a clinical diagnosis based on a combination of medical history, physical examination, and the exclusion of other possible conditions with similar symptoms. Here are the typical steps involved in diagnosing fibromyalgia:

1. Medical History: Your healthcare provider will start by taking a detailed medical history, including your symptoms, their duration, and any potential triggers or aggravating factors. They may ask about your family history, previous medical conditions, and any medications you are taking.
2. Widespread Pain: One of the hallmark criteria for fibromyalgia is the presence of widespread pain that has persisted for at least three months. This pain is typically present on both sides of the body, above and below the waist, and in the axial skeleton (such as the neck, chest, and back). Patients often describe the pain as a deep ache or burning sensation.
3. Tender Points: Historically, the American College of Rheumatology (ACR) established criteria for the diagnosis of fibromyalgia, which included the presence of tender points. These are specific areas on the body that are particularly sensitive to pressure. However, these criteria have been revised in recent years, and tender points are no longer considered the primary diagnostic criteria.
4. Widespread Symptoms: In addition to pain, fibromyalgia is associated with a variety of other symptoms, such as fatigue, sleep disturbances, cognitive difficulties (often referred to as “fibro fog”), and mood disturbances. These symptoms are often taken into account when making a diagnosis.
5. Differential Diagnosis: To confirm a diagnosis of fibromyalgia, your healthcare provider will rule out other conditions with similar symptoms, such as rheumatoid arthritis, lupus, multiple sclerosis, and other autoimmune or inflammatory disorders. Blood tests and imaging studies may be conducted to exclude these conditions.
6. Meeting Diagnostic Criteria: In 2010, the ACR published new diagnostic criteria for fibromyalgia that do not rely solely on tender points. These criteria include: a. Widespread pain index (WPI): A score based on the number of body regions where you have experienced pain in the past week.
   b. Symptom severity scale (SSS): A score based on the severity of your fatigue, unrefreshing sleep, and cognitive symptoms.
   c. A diagnosis of fibromyalgia is considered if the WPI and SSS scores meet certain thresholds.

It’s important to note that fibromyalgia is a diagnosis of exclusion, meaning that it is only considered after other potential causes of your symptoms have been ruled out.

If you suspect you have fibromyalgia or are experiencing chronic pain and other related symptoms, it is essential to seek evaluation and diagnosis from a healthcare professional, typically a rheumatologist or a primary care physician, who can provide appropriate care and management strategies. They may also recommend lifestyle changes, physical therapy, medications, and other interventions to help manage the condition.