How is fibromyalgia diagnosed?



Fibromyalgia is often difficult to diagnose as the symptoms vary considerably and can be similar to the symptoms of other conditions, for example an underactive thyroid gland (hypothyroidism). There aren’t any specific blood tests, x-rays or scans that can confirm a diagnosis of fibromyalgia, but your doctor may suggest you have blood tests to rule out other conditions.

Until recently, the diagnosis of fibromyalgia was made based on specific tender points in certain areas of your body, which can be tender even when pressed very gently. However, many people find that other areas are also painful.

Guidelines issued in 2010 recommend that healthcare professionals should also consider fatigue, waking up feeling unrefreshed and cognitive symptoms when making a diagnosis, as well as a history of pain lasting three months or more. – See more at:

We don’t yet know exactly what causes fibromyalgia, but research suggests that there’s an interaction between physical, mental and psychological factors. The pain we feel is often affected by our emotions and moods – depression or anxiety can make the pain seem worse. At the same time, being in pain can lead to stress and anxiety.

Some people with fibromyalgia report that their symptoms started after a viral infection, a physical or mental trauma (like a car accident or bereavement) or following a period of stress and anxiety, for example in a relationship. But in other cases, there seems to be no particular event leading up to the onset of symptoms.

Usually, pain is a result of a physical injury or illness that has damaged part of the body, but in fibromyalgia there is no damage or injury. The pain doesn’t have a physical cause but is something to do with the way the brain and nervous system process pain. This doesn’t mean the pain is any less real, but because there’s no physical cause that can be healed it’s often difficult to stop the pain. The pain of fibromyalgia therefore tends to be long-lasting (chronic) even though it doesn’t cause any permanent damage to the body’s tissues.

Research has shown that people with fibromyalgia are more sensitive to physical pressure. This means that what would be a relatively minor knock for most people could be extremely painful for someone with fibromyalgia. This increased sensitivity isn’t fully understood but it’s thought that it could be related to changes in the way the nervous system processes pain. Some researchers have shown using special brain scans that these processes are altered in people with fibromyalgia.

Sleep disturbance may also contribute to this increased sensitivity. Brainwave studies show that people with fibromyalgia often lose deep sleep. A number of things may lead to sleep disturbance, such as:

  • pain from an injury or another condition such as arthritis
  • stress at work or strain in personal relationships
  • depression brought on by illness or unhappy events.

In an experiment where healthy volunteers were woken during each period of deep sleep, a number of them developed the typical signs and symptoms of fibromyalgia. Not surprisingly, a combination of pain, sleep disturbance and anxiety or depression can turn into a vicious cycle. A poor sleep pattern will contribute to the severe tiredness that often goes with fibromyalgia.

Some people who have fibromyalgia also report being affected by:

  • chronic tiredness (fatigue)
  • depression and anxiety
  • headaches
  • joint pain in various parts of their body
  • restless leg syndrome – spasms in either one or both legs
  • irritable bowel syndrome (IBS)
  • temporomandibular joint disorder (TMJD), which causes problems with the joint connecting the jawbone to their skull, resulting in pain in their jaw and areas nearby
  • underactive thyroid (hypothyroidism).

The symptoms of fibromyalgia are often very similar to the symptoms of chronic fatigue syndrome, which was previously known as ME (myalgic encephalomyelitis). People with chronic fatigue syndrome can often recall a viral infection before symptoms appeared and may have less pain than people with fibromyalgia, but we need to know more about the conditions before we can say whether they’re the same thing.

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