Laughing and crying, you know it's the same release. Joni Mitchell

Laughing and crying, you know it's the same release. Joni Mitchell

Sunday, November 21, 2010

How Do I Know if I Have Fibromyalgia?

A friend of mine asked me that very question the other day. She has various aches and pains and feels fatigued enough that she needs to nap every day. First I told her to consult her physician. Other diseases or syndromes with similar symptoms such as lupus or rheumatoid arthritis need to be ruled out first. If my friend's doctor thinks fibromyalgia is a possible diagnosis then she should make an appointment with a rheumatologist.

The problem with diagnosing FMS is that is doesn't show up on any lab work, blood tests, x-rays or MRI's. Many people are misdiagnosed or told it's all in their heads. It can be hard to find a doctor who knows how to diagnose fibromyalgia let alone treat it. Finding a competent doctor is the first step.

In the old days - like back in 1997 when I was diagnosed - the diagnosis was based on as system of tender points affecting every quadrant of the body. If 11 or more of the 18 tender points were painful when pressure was applied, then fibromyalgia was the diagnosis. The doctor also looked at other symptoms, such as extreme fatigue, waking unrefreshed, brain cognition issues (the good old fibro fog), depression, irritable bowel syndrome and a whole host of other physical symptoms such as numbness and tingling, headache, and nausea.

While researching the diagnosis for fibromyalgia, I learned that there are new diagnostic criteria in 2010. Critics of the old system felt that it was too subjective and unreliable. Someone might have 11 painful tender points one day and only nine the next but still have FMS. The new system takes into account more symptoms than just the tender points and provides a scale for measuring the severity of the symptoms.

The widespread pain index (WPI) lists 19 areas of the body. The patient is given one point for each of the areas that have been painful in the last week for a scale of 0-19. For the symptom severity (SS) scale, the patient rates a list of symptoms on a scale of 1-3 for a total of 0-12.

For a diagnosis of fibromyalgia you need EITHER:
  1. WPI of at least 7 and SS scale score of at least 5, OR
  2. WPI of 3-6 and SS scale score of at least 9
To read more about it, take a look at The Fibromyalgia Diagnosis

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