Fibromyalgia diagnosis and misdiagnosis

Because of a multifaceted treatment approach that involves medication and lifestyle strategies, the prognosis for people with fibromyalgia is better than ever before. But first, a doctor needs to make an accurate diagnosis of fibromyalgia. Perhaps you are wondering how that's done?

Unfortunately, fibromyalgia is regularly misunderstood. Despite all the latest information about fibromyalgia with its severe muscle pain, unrelenting fatigue and sleep problems, and feelings of anxiety and depression, doctors are still misdiagnosing this common pain disorder. As a result, some patients are getting a diagnosis for the wrong condition, for example, chronic fatigue syndrome, arthritis, or some other pain problem.

What is fibromyalgia?

Fibromyalgia is a syndrome, also called fibromyalgia syndrome (FMS), with multiple symptoms that commonly occur together, including widespread pain, decreased pain threshold, tender trigger points, incapacitating fatigue, and anxiety or depression.

Why is diagnosing fibromyalgia difficult?

It takes on average five years for a person with fibromyalgia to get an accurate diagnosis. Some people go from doctor to doctor without receiving a medical diagnosis for their fibromyalgia symptoms. Many wonder if their painful symptoms are simply imagined.

There are no scientific measures, such as laboratory tests or X-rays that can "prove" you have fibromyalgia. In the past, millions of fibromyalgia patients were misdiagnosed as having depression, a type of inflammatory arthritis such as rheumatoid or lupus, chronic myofascial pain, or chronic fatigue syndrome. There are, of course, a few similarities between fibromyalgia and chronic fatigue syndrome and between fibromyalgia and arthritis. But fibromyalgia is different. It is a distinct condition that needs an accurate diagnosis and appropriate treatment.

What tests will my doctor use to diagnose fibromyalgia?

Most laboratory tests are not very useful by themselves for diagnosing fibromyalgia. Your doctor will come to a diagnosis after doing a physical examination and discussing your symptoms with you. The reason for this is that a diagnosis is, to large extent, based on the way you feel. For instance, even though your doctor may notice painful trigger points during the physical examination, you still need to tell them about the pain you feel in those areas.

Your doctor will arrange for a few laboratory tests to make sure you do not have a different medical condition. If your GP suspects you have FMS, he or she may refer you to a rheumatologist who specialises in the condition, although the necessary tests can usually be done at the GP surgery.

What specific tests will my doctor ask for?

Among the specific blood tests that your doctor may order is a full blood count (FBC). This test measures the haemoglobin levels, the number of red and white blood cells, and platelets. It can also find many common blood disorders, such as anaemia, that can cause fatigue.

Your doctor may ask for tests of kidney and liver function. Your doctor will probably want to know the level of cholesterol and other fats in your blood and calcium levels. Additionally, your doctor may run thyroid tests to see if your thyroid is overactive or underactive.