Diagnosing Fibromyalgia

Photo credit:  ericalaurend

Photo credit: ericalaurend

It’s not in your head! Fibromyalgia is a chronic pain disorder that causes widespread pain and muscle tenderness throughout the body. It also causes extreme fatigue, digestive problems, migraines, and sleep issues.

One of the big problems with fibro is that it’s often difficult to diagnose. Any person can walk into a doctor’s office and say they are suffering from exhaustion, but many of us often ignore the aches and pains until they become unbearable. As I mentioned in an earlier post, I have had migraines, muscle tenderness and joint pain for years prior to my fibro diagnosis.

One of the primary ways to diagnose fibromyalgia is by reviewing a your symptoms with your doctor. It may also be necessary to see a rheumatologist, who deals with autoimmune issues more regularly and thoroughly than an ordinary general practitioner. With fibromyalgia, pain sometimes affects several areas of the body, such as the shoulders, back, hips and legs, and is generally located both above and below the waist. It may become more intense in cold weather or during stressful periods.

For many people with fibromyalgia, extreme fatigue and/or insomnia is one of the main symptoms and often the reason people seek medical attention. Fibromyalgia patients often wake up still exhausted and fatigued even after 8 or more hours of sleep. Fatigue can also be so severe that it interferes with everyday activities, including maintaining a job, family responsibilities, and normal everyday activities.

Not all people with fibromyagia suffer from the same symptoms, which also adds to the difficulty in diagnosis. Other symptoms may include migraine headaches, restless leg syndrome, or sensitivity to bright light. Some patients may have (or may develop) anxiety and depression. Cognitive problems may also develop, including memory lapse and concentration difficulties, often referred to in the autoimmune community as “brain fog.”

There is no specific medical test to diagnose fibromyalgia. This definitely makes the diagnosis more challenging in that many of the symptoms of fibro are also symptoms of countless other issues.. According to the National Fibromyalgia Association, it takes about five years for a patient to be accurately diagnosed. For me, it took 2 years and three different doctors. Of course the jury isn’t in yet if I also suffer from early rheumatoid arthritis or lupus. Both keep getting thrown around because of the swelling in my hands and how quickly I went from being basically fine to feeling like I got hit by a truck.

It’s important to see a doctor if you’ve had one or more of these symptoms for a period of 2-3 months. Of course, if the your level of pain is more severe, don’t wait.

Traditionally, a rheumatologist will do a “tender point” exam. Established by the American College of Rheumatology in 1990, the tender point test designates 18 spots throughout the body as possible painful areas, located near various joints including the hips, elbows, and shoulders. During the exam, the physician applies pressure with a finger to the points.

A fibro diagnosis used to be made if 11 of the 18 trigger points experience tenderness. Although the tender point exam may still be helpful in making a diagnosis, its results aren’t considered a primary indication of fibromyalgia. One reason is with fibro (and other autoimmune diseases) symptoms may come and go, and trigger points may hurt one day and not another.

Doctors now consider widespread pain for more than three months to diagnose the condition. The problem is, fibromyalgia symptoms are very similar to those of other conditions, like RA and lupus. It’s not uncommon for patients to undergo several other medical and blood tests to rule out other conditions. It is also not uncommon for these symptoms to be present in anxiety and depression–another instance of what came first the pain or the depression?

For those of us dealing with fibro and other autoimmune issues, it’s not uncommon to have some sort of depression. Your life is in turmoil, not knowing how you will feel from one day to the next. It’s hard not to feel depressed if you’re cooped up in the house unable to move without pain. You may miss important events, etc. This isn’t easy on autoimmune sufferers. It’s one thing I struggle with. It’s difficult to make firm plans when you don’t know how you’re going to feel from one day to the next.

The bottom line is, if you are experiencing these symptoms, most importantly widespread pain (the spots can change from day to day), see your doctor and don’t stop asking questions until you get some answers. I have heard the talk that fibro is diagnoses when they can’t find anything truly wrong, but for those of us suffering with it, it’s very real.

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