Fibromyalgia - Diagnosis

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• Fatigue
• Unrefreshing sleep
• Cognitive symptoms

Another three points can be added for these additional symptoms:

• Numbness
• Dizziness
• Nausea
• Irritable bowel syndrome
• Depression

The WPI and SS scores are totaled to create a final score of between 0 and 12. To meet the criteria for a fibromyalgia diagnosis, a patient would have seven or more pain areas and a symptom severity score of five or more; or three to six pain areas and a symptom severity score of nine or more. The symptoms must have been present for at least 3 months.

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Medical and Personal History

A doctor should always take a careful personal and family medical history, which includes a psychological profile and history of any factors that might indicate other conditions, such as:

• Infectious diseases
• Muscle weakness
• Physical injuries
• Rashes
• Recent weight change
• Sexual, physical, or substance or alcohol abuse

Patients should report any drugs they take, including vitamins and over-the-counter or herbal medications.

Physical Examination

The physical exam may not reveal much, other than the tender spots that are included in the diagnostic criteria. These spots must be painful when pressed, not simply tender. In addition, for a doctor to reach a diagnosis of fibromyalgia, these tender sites should normally not show signs of inflammation (redness, swelling, or heat in the joints and soft tissue). The tender points may also change in location and sensitivity over time. A doctor may recheck tender points that do not respond the first time in patients who have other significant symptoms.

The health care provider will also examine the nails, skin, mucus membranes, joints, spine, muscles, and bones to help rule out arthritis, thyroid disease, and other disorders.

Other Tests

No blood, urine, or other laboratory tests can definitively diagnose fibromyalgia. If such tests show abnormal results, the doctor should look for other disorders. Tests for specific diseases depend on family histories and other symptoms, and may include:

• Blood count
• Sedimentation rate
• Tests of certain antibodies
• C-reactive protein
• Thyroid and liver function tests

The doctor may suggest follow-up psychological profile testing, if laboratory results do not indicate a specific disease.

Review Date: 12/27/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).