COMMON MISDIAGNOSES FOR FYBROMYALGIA
Fybromyalgia (FMS) is a debilitating disease that affects many people, most of them women. It is characterized by widespread chronic pain and fatigue with no known cause. It’s not fatal. Though the pain may not have been caused by an injury, it is real. When fybromyalgia is diagnosed properly, most people find the treatments that they need and wind up having a better quality of life. However, there are other conditions that mimic FMS making diagnosis often difficult.
The main symptom for FMS is widespread pain. It can be on the right and left side of the body and also above and below the waist. But the pain may also occur in only one or two places in the body, especially the neck and shoulders. However, fybromyalgia is not the only condition that has widespread pain.
Besides pain, another major symptom of fibromyalgia is chronic fatigue. But patients with other conditions also have chronic fatigue. Along with these, there are other symptoms that can also point to other conditions. These symptoms include:
- Thinking and memory problems (fibro fog)
- Headaches, both tension and migraine
- Sensitivity to temperature, light, and noise
- Irritable bowel syndrome
- TMJ syndrome
- Morning stiffness
- Numbing or tingling of the extremities
- Sleep disturbances
- Urinary problems
Any combination of these symptoms can be a sign of:
- Sleep apnea
- Rheumatoid arthritis
Another reason why FMS is difficult to diagnose is the fact that many of the symptoms group together and not all patients experience the same symptom groups. Therefore, because the symptoms can be the result of another condition, doctors have to rule out these other conditions first before diagnosing fybromyalgia. This is why it takes such a long time for diagnosis to be made. Tests and blood work have to rule out any other conditions and diseases.
Another problem with diagnosis can be the existence of another condition at the same time as FMS. For example, a person could have arthritis, or obstructive sleep apnea – all conditions that can mimic fibromyalgia – and also have fibromyalgia as a secondary condition. The problem is there are many health professionals who are unfamiliar with fybromyalgia and therefore limit themselves to treating only one disease without checking to see if fybromyalgia could be contributing to the symptoms.
OVERLY SPECIFIC DIAGNOSIS CRITERIA
Then there is the other side of the coin where doctors are being overly specific in their diagnosis and therefore, conclude that FMS is not the culprit. Until recently, the criteria for diagnosing FMS were limited to:
- A history of widespread pain with no evident cause that lasts three months or more
- Identification of at least 11 out of 18 tender points on the patient’s body
Tender points are locations on the body that may be unusually sensitive to light pressure. To identify tender points, the doctor applies pressure to the spot to gauge the patient’s reaction. This criteria helped set up a foundation whereby doctors could make a diagnosis of FMS. However, many experts feel these criteria are overly specific. In other words, if a patient has 10 out of 18 tender points, they would not be diagnosed with FMS. Also, men have less tender points than women but show other signs that point to FMS. In these cases, the patients may not be getting properly diagnosed.
Also, the tender point exam is not taught in many medical schools so many doctors are unfamiliar with the exam to properly diagnose FMS.
NEW DIAGNOSIS TECHNIQUES
In the last few years, a preliminary set of new criteria that does not rely on tender points has been laid out. The criteria will be easier for health care providers to use. The new criteria are based on a report of symptoms and an interview with the patient determining the severity of the symptoms and how widespread they are. This new approach is still being evaluated but doctors are optimistic that it will make it easier to identify fybromyalgia.
Of course, there are several things to think about when dealing with chronic disease. They are:
- Ongoing chronic pain that is widespread is not in your head. The pain is real and needs to be evaluated.
- Keeping a journal of your pain symptoms will make it easier to talk with your doctor about the pain. It will help make sure the doctor has the information needed to properly evaluate your condition.
- Consultation with a pain specialist who is familiar with fibromyalgia can help diagnose or rule out fibromyalgia as a cause of the pain.
There are effective treatments for fibromyalgia that can reverse the debilitating effect of the pain and greatly improve a person’s quality of life. Once you are properly diagnosed, you will be on your way to recovery.