Fybromyalgia (FMS) is marked by chronic pain and fatigue with no known cause. Though it is not fatal, many patients wish that they could die and get it over with. The pain and fatigue is real and often totally debilitating. Once properly diagnosed, patients can receive treatments that help to relieve symptoms of the syndrome. But diagnosing fibromyalgia is often difficult. Its symptoms can mimic those of other conditions. One of those symptoms is pain.
Widespread pain is one of the main symptoms of fibromyalgia. While you can have pain on the right and left side of the body and also have it above and below the waist, the pain may also occur in only one or two places in the body, especially the neck and shoulders.
Chronic fatigue is another major symptom of the syndrome. However, many other conditions exist that also have pain and chronic fatigue as symptoms. Therefore, diagnosing fybromyalgia may be very tricky and require time to rule out other conditions that may mimic the symptoms of FMS.
Here are some of the fybromyalgia symptoms that can also appear in other medical conditions.
- 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 also suggest the presence of these other serious illnesses, like:
- Sleep apnea
- Rheumatoid arthritis
The tendency for groups of symptoms to occur together in fibromyalgia patients is another reason fibromyalgia is hard to diagnose. However, the groups will not be the same for everyone. Therefore, not everyone with fibromyalgia will have all the symptoms described above. Because the symptoms may mimic other diseases, doctors will tend to want to rule out these other diseases before pursuing a diagnosis of fybromyalgia.
Many patients with fybromyalgia also have other conditions that complicate diagnosis. For example, a person could have Lyme disease; a condition that can mimics fibromyalgia, and also have fibromyalgia as a secondary condition. In these cases, health professionals, especially those unfamiliar with fibromyalgia, limit themselves to treating one disease and do not check whether fibromyalgia could be contributing to the symptoms.
OVERLY SPECIFIC DIAGNOSTIC CRITERIA
The first accepted criteria for a formal diagnosis of fibromyalgia was established in 1990 by the American College of Rheumatology. First, a history of widespread pain with no evident cause that lasts three months or more was ascertained. Then an identification of at least 11 out of 18 tender points on the patient’s body was critical for diagnosis. The tender points are locations on the body that may be unusually sensitive to light pressure. Doctors identify tender points by applying pressure to the spot to evaluate the patient’s reaction. The criteria were helpful in that it set up an objective way to identify people with fibromyalgia. But some experts and patients feel the criteria may be too specific.
For example, people with unexplained widespread pain who had only have 10 or fewer tender points could not be identified by this method of diagnosis. As a result, someone with 10 of the 18 tender points would not technically be diagnosed as having fibromyalgia. Also, since men are 10 times less likely than women to develop tender points, some men with other symptoms of fibromyalgia besides tender points were not be getting properly diagnosed.
Another dilemma that arose by using tender points as criteria for fibromyalgia was the fact that with treatment, the tender points in many people lessened. So that raised a question: does a person still have fibromyalgia if he or she no longer has 11 tender points?
Yet another problem was that the exam itself. This process for identifying tender points had seldom been taught in medical schools. Therefore, many doctors did not know how to properly perform the exam.
NEW DIAGNOSTIC APPROACH MAKES DIAGNOSIS EASIER
During the last few years, the American College of Rheumatology has been revising the criteria for diagnosing fibromyalgia. Now there is now an initial set of new criteria that does not rely on tender points. The criteria will be easier for doctors to use.
The new criteria are based on a report of symptoms by the patient. A patient interview determines the severity of the symptoms and how widespread they are in the body. Though the new criteria are being evaluated, experts are confident that it will make diagnosing fybromyalgia easier in patients.
When dealing with chronic pain and fatigue, there are several things to keep in mind:
- Ongoing, chronic pain that is widespread is not in your head but is real and needs to be evaluated.
- By keeping a journal of your pain symptoms, it will be easier to talk with your doctor about the pain. With a journal, your doctor will have the information needed to properly evaluate your condition.
- Arrange for a consultation with a pain specialist (usually a rheumatologist) who is familiar with fibromyalgia. He or she can help diagnose or rule out fibromyalgia as a cause of the pain.
There are effective treatments for fibromyalgia that can reverse the debilitating effects of the pain and fatigue and greatly improve a person’s quality of life. Finding these treatments takes patience and time but the efforts will be worth it.