Before doctors can diagnose fibromyalgia, they need to rule out a host of other conditions. Typically, they'll order blood tests to rule out other medical disorders with similar symptoms, including hypothyroidism, infections, polymyalgia rheumatica, rheumatoid arthritis or lupus.
Doctors may also order other lab and imaging tests. Until recently, no test could definitively diagnose fibromyalgia, but a new blood test is is now showing promise in some preliminary studies. It involves antipolymer antibodies, which may be found in about half of the people with FMS.
Fibromyalgia is typically diagnosed and treated by rheumatologists. The American College of Rheumatology in 1992 established two criteria for a diagnosis of fibromyalgia:
- Pain in all four quadrants of the body and in the axial skeleton (bones of the head, throat, chest and spine) that's been present on a more-or-less continuous basis for at least three months.
- Pain in at least 11 of 18 tender points, which are specific spots on the body that hurt when pressure is applied. (See diagram, top right.)
Since the 1990s, fibromyalgia primarily has been treated by rheumatologists, but now that it's being regarded more as a neurological condition some neurologists also are treating it. Even so, it can be difficult to find a doctor who's willing and able to effectively diagnose and treat fibromyalgia.
Sources:
American College of Rheumatology, 2007"Fibromyalgia"
Regina P. Gilliland, MD, Department of Internal Medicine; Division of Rehab Medicine, Mobile Infirmary Medical Center"Fibromyalgia"
